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Related Experiment Videos

Thyroid carcinoma presenting as an enlarged cervical lymph node

J N Attie1, M Setzin, I Klein

  • 1Department of Surgery, North Shore University Hospital, Manhasset, New York.

American Journal of Surgery
|October 1, 1993
PubMed
Summary
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Differentiated thyroid cancer can initially present as an enlarged cervical lymph node, often with small primary tumors. Surgical management, including neck dissection, yields favorable long-term outcomes for these patients.

Area of Science:

  • Oncology
  • Surgical Pathology
  • Endocrinology

Background:

  • Differentiated thyroid cancer typically presents as a thyroid nodule.
  • Cervical lymph node metastases are a frequent finding in differentiated thyroid cancer.
  • However, initial presentation as an enlarged cervical lymph node is less common.

Purpose of the Study:

  • To describe the clinical characteristics, pathological findings, surgical management, and long-term outcomes of differentiated thyroid cancer presenting initially as an enlarged cervical lymph node.

Main Methods:

  • Retrospective review of 43 patients with differentiated thyroid cancer initially presenting with an enlarged cervical lymph node.
  • Analysis of clinical presentation, pathological findings (including primary tumor size and histology), surgical approach (thyroidectomy with or without modified neck dissection), and patient follow-up.

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Main Results:

  • 65% of patients had additional lymph node involvement at surgery.
  • Papillary carcinoma was the histology in all cases.
  • Two-thirds of primary thyroid tumors were 1 cm or smaller.
  • 30 out of 43 patients (69.8%) remain alive and disease-free after a mean follow-up of 14.8 years.

Conclusions:

  • Differentiated thyroid cancer presenting as an enlarged cervical lymph node, even with small primary tumors, can be effectively managed with surgery.
  • Surgical intervention, often involving thyroidectomy and modified neck dissection, leads to favorable long-term survival and disease control in this patient cohort.