Parapharyngeal metastasis from papillary thyroid carcinoma: a case diagnosed by thyroglobulin measurement in peroral fine-needle aspiration of a cystic metastatic lymph node

Tomoda, Chisato; Matsuzuka, Fumio; Miyauchi, Akira

doi:10.1258/0022215053419952

Cited by 10 publications

(9 citation statements)

References 12 publications

(22 reference statements)

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“…Desuter et al [6] reported that only 0.43% (3/696) of thyroid papillary carcinomas had parapharyngeal node metastasis. During the last two decades, looking at only cases with histologically definite diagnosis by surgery, only 39 reported cases were found in the literature (Tables I and II) [6][7][8][9][10][11][12][13][14][15]. Therefore, we reviewed the literature of those 39 cases.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of node metastasis usually occurs in the internal jugular and recurrent laryngeal chain on the side of the lesion [4,5], so metastasis to the retropharyngeal lymph nodes (RPLN) or parapharyngeal lymph nodes (PPLN) is very rare. Only 39 cases (limited to the cases with histologically definite diagnosis by surgery) have been reported during the last two decades within our literature review (Tables I and II) [6][7][8][9][10][11][12][13][14][15]. Meanwhile, it was reported that there were two lymphatic pathways that connected with a retropharyngeal metastasis from thyroid carcinomas, one is retrograde from jugular chain lymphatics, and the other is direct through the superior thyroid pole by way of the posterior lymphatic trunks, which are reported to be present in 20% of the cases [16].…”

Section: Introductionmentioning

confidence: 99%

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The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature

Kainuma

Kitoh

Yoshimura

et al. 2011

Acta Oto-Laryngologica

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The sites of lymph node metastasis of papillary thyroid carcinomas are typically the paratracheal and jugular lymph nodes. On the other hand, metastasis to the retropharyngeal or parapharyngeal nodes from papillary thyroid carcinomas is very rare. During the last two decades, limited to cases with a histologically definite diagnosis by surgery, only 39 cases have been reported. All reported cases were unilateral retropharyngeal or parapharyngeal node metastasis except one metachronous bilateral case, and there were no reports of simultaneous bilateral cases within our literature review. We report three cases of retropharyngeal node metastasis from thyroid papillary carcinoma, including a case of bilateral nodal metastasis. Retropharyngeal node metastasis was successfully resected in all three patients by the transcervical approach. As pointed out in past reports, this report also suggests that prior neck dissection and/or metastasis to cervical lymph nodes might alter the direction of lymphatic drainage to the retrograde fashion, resulting in the unusual metastasis to the retropharyngeal lymph nodes, and there is a possibility of a bilateral pattern. Also, it is necessary to consider the possibility of metastasis from a papillary thyroid carcinoma in the differential diagnosis of lymph node swelling in the parapharyngeal space.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature

Kainuma

Kitoh

Yoshimura

et al. 2011

Acta Oto-Laryngologica

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“…Totally, two relatively large numbers of DTC cases with parapharyngeal metastases have been described, suggesting that the incidence rate of parapharyngeal metastasis is extremely low (Desuter et al 2004). Parapharyngeal mass is often nonspecific or asymptomatic when the tumor does not exceed 3.0 cm in size (Tomoda et al 2005). Frequently, patients complain of a mass in the neck or oropharynx that causes dysphagia.…”

Section: Parapharyngeal Metastasismentioning

confidence: 99%

Rare metastases of differentiated thyroid carcinoma: pictorial review

Song

Xue²,

Xu³

et al. 2011

Endocrine-Related Cancer

127

148

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Differentiated thyroid cancer (DTC) is usually indolent with good prognosis and long-term survival. However, DTC distant metastasis is often a grave event and accounts for most of its diseasespecific mortality. The major sites of distant metastases are the lung and bone. Metastases to the brain, breast, liver, kidney, muscle, and skin are rare or relatively rare. Nevertheless, recognizing rare metastases from DTC has a significant impact on the clinical decision making and prognosis of patients.131 I single photon emission computed tomography/computed tomography ( 131 I-SPECT/CT) can provide both metabolic and anatomic information about a lesion; therefore, it can better localize and define the 131 I-WBS findings in DTC patients. In this pictorial review, the imaging features of a range of rare metastases from DTC are demonstrated, with a particular emphasis on the 131 I-SPECT/CT diagnostic aspect.

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“…Based on several reports investigating isolated cervical cystic masses related to papillary thyroid cancer, preoperative tissue sampling through fine needle aspiration (FNA) may aid in the differential diagnosis of cervical masses. [1,2] However, mere microscopic evaluation of fine-needle aspirates might not be sufficient for adequate diagnosis since they are commonly false negative. [3] Instead, thyroglobulin measurements in the specimen have been proven helpful for accurate diagnosis of cystic lesions as thyroid metastases.…”

Section: Discussionmentioning

confidence: 99%

Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck

Schwaiger

Koeninger²,

Wimbauer³

et al. 2019

Medicine

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Rationale: Papillary thyroid cancer accounts for up to 85% of all cases of thyroid carcinoma. This disease entity is notorious for metastatic invasion of adjacent lymph nodes, including the cervical lymph nodes, potentially presenting as a growing lateral neck mass. However, these lesions tend to be recognized and diagnosed soon due to the palpable mass. Patient concerns: This report describes a very rare case of a huge slow-growing neck metastasis based on a 6 mm papillary thyroid microcarcinoma. This patient presented with a painless, but continuously growing right lateral neck mass. Aside from that, no specific complaints were mentioned. Diagnosis: The underlying cause of this patient's neck mass turned out to be an occult papillary thyroid microcarcinoma (Ø 6 mm) with metastatic invasion and subsequent cystic degeneration of cervical lymph nodes. Accurate diagnosis was made after surgical intervention through histopathological analysis. Interventions: The patient underwent complete resection of the cervical mass in conjunction with total thyroidectomy and right cervical neck dissection, followed by adjuvant iodine- and chemotherapy. Outcome: Margin free surgical resection without any postoperative complications could be achieved. The patient received iodine supplementation and remained free of recurrence during regular clinical follow-ups for 2 years. The therapy was curative. Lessons: This case report emphasizes the importance of a thorough diagnostic work-up including preoperative tissue sampling of any cervical neck mass, since a benign appearance on imaging does not exclude a malignant process.

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Parapharyngeal metastasis from papillary thyroid carcinoma: a case diagnosed by thyroglobulin measurement in peroral fine-needle aspiration of a cystic metastatic lymph node

Cited by 10 publications

References 12 publications

The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature

The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature

Rare metastases of differentiated thyroid carcinoma: pictorial review

Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck

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