Thyroid Cancer Discovered Incidentally during Treatment for an Unrelated Head and Neck Cancer

The prevalence and significance of clinically unsuspected neoplasms in cervical lymph nodes

“…This finding is consistent with the 0.7% prevalence rate reported by Clark et al 7 in their study of 1516 patients who underwent lymph node dissections for nonthyroid head and neck cancers. The true prevalence of metastatic thyroid cancer is undoubtedly much higher.…”

Significance and management of thyroid lesions in lymph nodes as an incidental finding during neck dissection

“…While the rarity of this entity has limited our ability to review a cohort of patients large enough to derive statistical significance, our findings support prior work 6,16,20 that suggests that the presence of malignant thyroid tissue within a lymph node is predictive of an undetected primary thyroid malignancy. Patient 5 had incidentally discovered benign-appearing thyroid follicles in a lymph node but no evidence of a primary thyroid gland malignancy.…”

“…The rarity of this entity limits our ability to derive statistically significant results. However, it is clear from our data and previously published work 1,6,8,20 that in the presence of incidentally discovered well-differentiated thyroid metastases, a negative physical exam and thyroid ultrasound does not preclude the possibility of a clinically undetected thyroid carcinoma requiring appropriate surgical management. We cannot conclude that all patients require surgical intervention or conservative management, but we offer a diagnostic algorithm (Fig.…”

“…8,9,17,18 Clay and Blackman 19 in 1944, in contrast to Lahey and Ficarra, 13 contended that lateral aberrant thyroid tissue represented cervical lymph node metastases from a primary thyroid carcinoma despite the presence of a normal thyroid gland. In 1966, Clark et al 20 retrospectively reviewed 1,516 patients in which neck dissections were performed for cancers of nonthyroid origin. Sixteen patients were found to have well-differentiated thyroid carcinoma in cervical lymph nodes.…”

Incidental thyroid carcinomas. A retrospective study

“…It is then argued if incidental carcinomas also include the carcinomas discovered at the definitive histological examination, after total thyroidectomy for multinodular goiter (26)(27)(28)(29)(30)(31)(32)(33) or during treatment of an unrelated head and neck cancer (34). There is no doubt that the latter are also an occasional finding within parenchymas where multinodularity and poor response to medical therapy become responsible for an inalienable surgical choice.…”