Incidental cervical metastases from thyroid carcinoma during neck dissection

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• 作者：S. Pé ; rié ; ^a ; ^{sophie.perie@aphp.fr} ; F. Torti^a ; M. Lefevre^b ; N. Chabbert-Buffet^c ; A. Jafari^a ; J. Lacau St Guily^a
• 关键词：Cervical lymph node metastasis of thyroid carcinoma ; Head and neck squamous cell carcinoma ; Papillary thyroid carcinoma ; Neck dissection
• 刊名：European Annals of Otorhinolaryngology, Head and Neck Diseases
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：133
• 期：6
• 页码：383-386
• 全文大小：854 K
• 卷排序：133

文摘

To quantify and discuss the prevalence of unsuspected thyroid lymph node metastases discovered in specimens from neck dissection for head and neck squamous cell carcinoma (HNSCC) and discuss the impact on patient management.Study designRetrospective study between May 2004 and January 2007.SettingUniversity hospital.MethodsPathological analysis of cervical lymph node dissection performed during surgery for HNSCC in a total of 349 neck dissections in 266 consecutive patients.ResultsTwenty-one patients showed metastatic lymph nodes from thyroid cancer (prevalence 7.9%): 13 cases were metastatic from a papillary thyroid carcinoma and 8 cases from a follicular carcinoma. In 5 of the 21 patients, classical dissection was associated to recurrent nerve dissection and unilateral lobectomy; no thyroid carcinoma was found. Thirteen patients received radiotherapy for HNSCC.Follow-up comprised annual ultrasonographic examination of the neck and thyroid in these 21 patients. Total thyroidectomy was decided on in 5, with discovery of 3 micro-papillary thyroid carcinomas, in a single patient (complementary 131I treatment). No thyroid carcinomas were found for the other 4 patients. No patients died from thyroid carcinoma during follow-up (mean: 41 months).ConclusionThe prevalence of lymph node metastasis from thyroid carcinoma in cervical lymph node dissection during treatment of HNSCC seems higher (7.9%) than rates reported in the literature (0.3 to 1.6%). This may be due to the histopathological methods employed. Management of patients should be discussed in the light of thyroid ultrasonography and prognosis of HNSCC.