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Pattern and Distribution of Lymph Node Metastases in Papillary Thyroid Cancer | OMICS International| Abstract
ISSN: 2161-0681

Journal of Clinical & Experimental Pathology
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  • Research Article   
  • J Clin Exp Pathol 2015, Vol 5(2): 204
  • DOI: 10.4172/2161-0681.1000204

Pattern and Distribution of Lymph Node Metastases in Papillary Thyroid Cancer

Hossam A El-Foll1, Hesham I El-Sebaey2, Ahmad F El-Kased1, Ali Hendawy3 and Mahmoud M Kamel4*
1Department of Surgical Oncology, Faculty of Medicine, Menofia University, Egypt
2Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt
3Department of Surgical Pathology, Faculty of Medicine, Cairo University, Egypt
4Department of Clinical Pathology, National Cancer Institute, Cairo University, Egypt
*Corresponding Author : Mahmoud M Kamel, Department of Clinical Pathology, National Cancer Institute, Cairo University, Egypt, Tel: 00201272072075, Email: [email protected]

Received Date: Dec 09, 2014 / Accepted Date: Dec 26, 2014 / Published Date: Jan 03, 2015

Abstract

Background: The indications and extent of lymph node dissection in the treatment of papillary thyroid carcinoma remains controversial, and benefit from therapy is debatable. This study was designed to identify the pattern and distribution of lymph node metastases and to establish an optimal strategy for neck dissection for those patients.

 

Methods: A total of 44 patients diagnosed with papillary thyroid cancer were treated from 2006 to 2013. All patients underwent total thyroidectomy, central neck dissection, and ipsilateral selective neck dissection removing lymphatic structures in levels II through V. The frequency of cervical lymph node metastases in each level, and the presence of capsular invasion were analysed. In addition, we investigated postoperative complications after total thyroidectomy and central lymph node dissection.

 

Results: Lymph node metastases were found in 18 patients (40.9%); all of them had ipsilateral level VI nodal involvement. 7 patients had level V involvement, 2 patients had level II affection, 3 patients had level III & IV affection and 2 patients had contralateral level VI lymph node affection. We also found extracapsular invasion in 6 (13.6%) patients and grade I, II, III in 2, 40, 2 patients respectively. The frequency of temporary hypocalcaemia, permanent hypocalcaemia and temporary vocal cord paralysis were 6.8%, 2.3% and 4.5%, respectively.

 

Conclusion: We recommend total thyroidectomy and central compartment lymph node dissection. If ipsilateral central lymph nodes are positive for metastases in frozen section, we proceed to ipsilateral selective neck dissection removing lymphatic structures in levels II through V even in the absence of clinically evident lymph node metastasis irrespective of tumor size. The technique had a low rate of complications; namely laryngeal nerve injury and hypoparathyroidism.

Keywords: Papillary thyroid carcinoma; Total thyroidectomy; Lymph node metastases; Neck dissection

Citation: El-Foll HA, El-Sebaey HI, El-Kased AF, Hendawy A, Kamel MM (2015) Pattern and Distribution of Lymph Node Metastases in Papillary Thyroid Cancer. J Clin Exp Pathol 5:204. Doi: 10.4172/2161-0681.1000204

Copyright: © 2015 El-Foll HA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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