Meeting abstract
Contralateral neck lymph node metastasis as a primary presentation of papillary thyroid microcarcinoma
Ivan Abičić
orcid.org/0009-0003-2753-0503
; KBC Osijek, Osijek, Hrvatska
Anamarija Šestak
; KBC Osijek, Osijek, Hrvatska
Tin Prpić
; KBC Osijek, Osijek, Hrvatska
Matej Rezo
; KBC Osijek, Osijek, Hrvatska
Abstract
Background: Papillary thyroid cancer usually follows a certain order of metastases to the lymph nodes of the
neck. We present a case report of a patient with the primary presentation of the cancer in the form of a
metastasis in the lateral neck compartment. Case report: A 22-year-old woman was referred for a painful
nodule in region IV on the right side of the neck. Ultrasound showed a hypoechoic nodule measuring
0.5×0.4×0.6 cm in the left thyroid lobe and a hypoanechoic nodule measuring 2.5×2.0×3.1 cm in region IV on
the right side of the neck. The FNAC finding of a nodule in region IV indicated the metastasis of papillary
thyroid cancer, while the finding of the nodule in the left thyroid lobe did not indicate the presence of tumor
cells. The multidisciplinary team decided to perform a total thyroidectomy with a selective neck dissection IIVI on the right side. The pathohistological analysis ultimately confirmed a papillary microcarcinoma (0.3 cm)
in the left thyroid lobe, and a metastasis in the lymph node in region IV on the opposite side. Conclusion:
Papillary cancer normally follows a certain sequence of metastases, and the central neck compartment is most
often affected. In very rare cases, metastases can be seen in the lateral neck department without metastases in
the central neck department (the so-called skipped metastases). From the presented case of the patient, a good
preoperative evaluation and a discussion of the optimal surgical strategy by a multidisciplinary team is of
utmost importance.
Keywords
papillary thyroid microcarcinoma; skip metastases; multidisciplinary team; pathohistological analysis
Hrčak ID:
308033
URI
Publication date:
19.9.2023.
Visits: 153 *