Aims and objectives
The incidence of thyroid cancer is rapidly rising at the rate of 4% per year.1 There are controversies connected with the surgical approach and follow-up after surgery of thyroid cancer.2,3Assessment of cervical lymph nodes is essential for patients with head and neck carcinomas because it helps to determine the prognosis and select appropriate treatment.1
Differentiated thyroid cancers may be associated with regional lymph node metastases in 20-50% of cases.
Lymph node metastases are frequent (20-50%) and up to 15% of patients will develop a regional...
Methods and materials
PATIENTS
A prospective study was conducted and we investigated 94 necks of postoperative patients of thyroid cancer,
determining ultrasonography characteristics of malignant lymph nodes,
from February 2012 to September 2013 in the University State of São Paulo (USP).
Institutional review board approval was obtained for this study.
Sonographic images of the cervical lymph nodes of patients in this study were obtained from B-mode and color Doppler amplitude.Ultrasound was held at E9 equipment - GE or Phillips iU22,
equipped with a multifrequency linear probe 7-12 MHz,...
Results
The 22 necks with suspicious lymph nodes,
were submitted a surgery,
where 712 lymph nodes were histological analyzed and 114 were malignant lymph nodes,
confirmed by surgery.
Levels malignant cervical lymph nodes had this distribution: 12 lymph nodes on level II (10.6%),
13 lymph nodes on level III (11.5%),
51 lymph nodes on level IV (44.7%),
8 lymph nodes on level V (7.1%),
27 lymph nodes on level VI (24%),
3 lymph nodes on level VII (2.6%).
Summary of data acquired for 22 patients operated...
Conclusion
Levels IV and VI cervical lymph nodes were the most frequents of recurrence.
Given this greater frequency of involvement of level IV and VI of the cases of cervical lymph node recurrences after thyroidectomy for thyroid cancer should review the possibility of better surgical exploration of these levels and better ultrasound evaluation previous surgery to the identification of lymph nodes.
Personal information
MRM MACHADO,Department of Radiology,
University of São Paulo
[email protected]; MC CHAMMAS,
doctor of Hospital das Clínicas da Faculdade de Medicina da Universidade of São Paulo (USP),
Medical Director of Service of Ultrasound (USP); MR TAVARES,
Doctor and professor of Department of Head and Neck Surgery,
University of São Paulo; GG CERRI,
Chairman of Department of Radiology and Oncology of Faculdade de Medicina da University of São Paulo.
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