Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T01:26:24.591Z Has data issue: false hasContentIssue false
  • English
  • Français

Incidental nodal metastasis of differentiated thyroid carcinoma in neck dissection specimens from head and neck cancer patients

Published online by Cambridge University Press:  28 February 2017

R Lenzi ,
M Marchetti  and
L Muscatello
R Lenzi*
Affiliation:
Division of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Ospedale delle Apuane, Massa, Italy
M Marchetti
Affiliation:
Division of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Ospedale delle Apuane, Massa, Italy
L Muscatello
Affiliation:
Division of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Ospedale delle Apuane, Massa, Italy
*
Address for correspondence: Dr R Lenzi, Division of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Ospedale delle Apuane, Via Enrico Mattei, 21, 54100 Massa, Italy Fax: +39 0585 498269 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Occult differentiated thyroid carcinomas are not uncommon. The initial presentation of a thyroid carcinoma is often detection of a metastatic cervical lymph node.

Methods:

A retrospective review was performed of the medical records of 304 patients who underwent neck dissection between 1996 and 2008 for squamous cell carcinoma of the head and neck.

Results:

Ten patients (3.3 per cent) had nodal metastasis originating from papillary thyroid cancer. All of these patients underwent thyroidectomy and post-operative 131iodine radiometabolic therapy. No patient developed a thyroid tumour after surgery.

Conclusion:

Despite its metastatic spread, thyroid cancer does not affect the overall prognosis of patients who are already being treated for a more aggressive malignancy. However, in otherwise healthy patients, it is worth treating this second malignancy to avoid potential complications related to local disease or metastatic thyroid cancer.

Keywords

Head and Neck NeoplasmsIncidental FindingsNeck DissectionThyroid NeoplasmsThyroidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 4 , April 2017 , pp. 368 - 371
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Nishiyama, RH, Ludwig, GK, Thompson, NW. The prevalence of small papillary thyroid carcinomas in 100 consecutive necroses in the American population. In: De Groot, LJ, Frohman, LA, Kaplan, EL, Refetoff, S, eds. Radiation associated thyroid carcinomas. New York: Grune & Stratton, 1977;123 Google Scholar
2 Sampson, RJ. Prevalence and significance of occult thyroid cancer. In: De Groot, LJ, Frohman, LA, Kaplan, EL, Refetoff, S, eds. Radiation associated thyroid carcinomas. New York: Grune & Stratton, 1977;137 Google Scholar
3 Bisi, H, Fernandes, VSO, Asato de Camargo, R, Koch, L, Abdo, AH, de Brito, T. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma. Cancer 1989;64:1888–93Google Scholar
4 Autelitano, F, Spagnoli, LG, Santeusanio, G, Villaschi, S, Autelitano, M. Occult carcinoma of the thyroid gland: an epidemiological study of autopsy material. Ann Ital Chir 1990;61:141–6Google Scholar
5 Harach, HR, Franssila, KO, Wasenius, VM. Occult papillary carcinoma of the thyroid: a ‘normal’ finding in Finland: a systematic autopsy study. Cancer 1985;56:531–8Google Scholar
6 Allo, MD, Christianson, W, Koivunen, D. Not all ‘occult’ papillary carcinomas are ‘minimal’. Surgery 1988;104:971–6Google Scholar
7 Vassilopoulou-Sellin, R, Weber, RS. Metastatic thyroid cancer as an incidental finding during neck dissection: significance and management. Head Neck 1992;14:459–63Google Scholar
8 Nussbaum, M, Bukachevsky, R. Thyroid carcinoma presenting as a regional neck mass. Head Neck 1990;12:114–17Google ScholarPubMed
9 Butler, JJ, Tulinius, H, Ibanez, ML, Ballantyne, AJ, Clark, RL. Significance of thyroid tissue in lymph nodes associated with carcinoma of the head, neck or lung. Cancer 1967;20:103–12Google Scholar
10 Kozol, RA, Geelhoed, GW, Flynn, SD, Kinder, B. Management of ectopic thyroid nodules. Surgery 1993;114:11103–7Google ScholarPubMed
11 Block, MA, Wylie, JH, Patton, RB, Miller, JM. Does benign thyroid tissue occur in the lateral part of the neck? Am J Surg 1966;112:476–81Google Scholar
12 Meyer, JS, Steinberg, LS. Microscopically benign thyroid follicles in cervical lymph nodes. Cancer 1969;24:302–11Google Scholar
13 Fliegelman, LJ, Genden, EM, Brandwein, M, Mechanic, J, Urken, ML. Significance and management of thyroid lesions in lymph nodes as an incidental finding during neck dissection. Head Neck 2001;23:885–91Google Scholar
14 Ansari-Lari, MA, Westra, WH. The prevalence and significance of clinically unsuspected neoplasm in cervical lymph nodes. Head Neck 2003;25:841–7Google Scholar
15 Miccoli, P, Minuto, MN, Galleri, D, D'Agostino, J, Basolo, F, Antonangeli, L et al. Incidental thyroid carcinoma in a large series of consecutive patients operated on for benign thyroid disease. ANZ J Surg 2006;76:123–6Google Scholar
16 Minuto, MN, Miccoli, M, Viola, D, Ugolini, C, Giannini, R, Torregrossa, L et al. Incidental versus clinically evident thyroid cancer: A 5-year follow-up study. Head Neck 2013;35:408–12Google Scholar
17 De Jong, SA, Demeter, JG, Jarosz, H, Lawrence, AM, Paloyan, E. Primary papillary thyroid carcinoma presenting as cervical lymphadenopathy: the operative approach to the ‘lateral aberrant thyroid’. Am Surg 1993;59:172–6Google Scholar
18 Clark, RL, Hickey, RC, Butler, JJ, Ibanez, ML, Ballantyne, AJ. Thyroid cancer discovered incidentally during treatment of an unrelated head and neck cancer: review of 16 cases. Ann Surg 1966;163:665–71Google Scholar
19 Gerard-Marchant, R. Thyroid follicle inclusions in cervical lymph nodes. Arch Pathol 1964;77:633–7Google Scholar
20 Rosai, J, Carcangiu, M, DeLellis, R. Thyroid tissue in abnormal locations. In: Rosai, J, Carcangiu, M, DeLellis, R, eds. Tumors of the thyroid gland. Washington DC: Armed Forces Institute of Pathology, 1990;317–26Google Scholar
21 Park, CS, Min, JS. Lateral neck mass as the initial manifestation of thyroid carcinoma. Head Neck 1989;11:410–13Google Scholar
22 Clay, RC, Blackman, SS Jr. Lateral aberrant thyroid: metastases to the lymph nodes from primary carcinoma of the thyroid gland. Arch Surg 1944;48:223–8Google Scholar
23 Pacheco-Ojeda, L, Micheau, C, Luboinski, B, Richard, J, Travagli, JP, Schwaab, G et al. Squamous cell carcinoma of the upper aerodigestive tract associated with well-differentiated carcinoma of the thyroid gland. Laryngoscope 1991;101:421–4Google Scholar
24 Leòn, X, Sancho, FJ, Garcìa, J, Sañudo, JR, Orús, C, Quer, M. Incidence and significance of clinically unsuspected thyroid tissue in lymph nodes found during neck dissection in head and neck carcinoma patients. Laryngoscope 2005;115:470–4Google Scholar
25 Yamamoto, T, Tatemoto, Y, Hibi, Y, Ohno, A, Osaki, T. Thyroid carcinomas found incidentally in the cervical lymph nodes: do they arise from heterotopic thyroid tissues? J Oral Maxillofac Surg 2008;66:2566–76Google Scholar