Purpose
Thyroid cancer is the most common endocrine malignancy.
It is classified into well differentiated and undifferentiated carcinomas.
The well differentiated thyroid cancer (DTC) derives from follicular epithelial cells and includes papillary,
follicular,
Hürthle cell and a mixed variety carcinomas.
The undifferentiated thyroid cancer includes medullary carcinoma,
anaplastic cancer,
lymphoma and metastatic tumors.
DTC represents more than 90% of primary thyroid cancers and is best treated with total thyroidectomy (TT) and functional lymph node dissection,
followed by radioactive iodine ablation therapy and performance of a post...
Methods and Materials
During a period offiveyears (2006-2010),
we performed U/S examinations of the neck region in 285 patients (265 women; mean age,
43.2 years; range,
17–89 years) with known thyroid cancer,
looking for potential metastases before surgery as well as in postoperative follow-up,
without an already clinical known recurrent or residual thyroid cancer.
This was a retrospective study of 365 non palpable cervical lymph nodes detected sonographically and verified by real-time (Rt) ultrasonography-guided (Ug) fine-needle non-aspiration cytology (FNNAC) -Rt-Ug-FNNA(9).
Nodes were measured on the screen,
and their...
Results
All the 285 patients had a known thyroid malignancy,
which was included in the DTC group.
55% of the patients were in the phase of primary staging and treatment of a preoperatively diagnosed DTC ( Fig. 10,
Fig. 11) and 45% had undergone TT with or without central neck dissection for DTC,
without a clinical known residual or recurrent thyroid cancer.
Cytological diagnosis could be made by Rt-Ug-FNNAC in 282 of the 285 patients yielding a diagnostic rate of 98.9%.
365 cervical lymph nodes underwent...
Conclusion
Early detection of metastatic lymph nodes is of great clinical importance because it enables more successful surgical results and radiation therapy treatment outcomes in a balanced decision between the need for achieving local radical excision,
correct disease staging,
and reducing the risk of complications (2-5,
14).
Sonography itself cannot distinguish benign from malignant nodes in patients with thyroid malignancy,
especially if the nodes are small and unpalpable.
However,
U/S appearance suggests malignancy and helps in the selection of the node for Rt-Ug-FNNAC,
which is crucial...
References
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Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency,
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Is central neck dissection a safe procedure in the treatment of papillary thyroid cancer? Our experience.
Langenbecks Arch Surg 2008; 393:693-698.
Shan CX,
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Jiang DZ,
et...
Personal Information
M.G.
Gkeli,
M.
Milatou,
K.
Kavvadias.First Department of Radiology,
Anticancer Oncological Hospital of Athens,
Alexandras Avenue 171,
11522,
Athens,
GREECE.
mail to:
[email protected]
