J Korean Thyroid Assoc.  2014 Nov;7(2):129-135. 10.11106/cet.2014.7.2.129.

Regional Lymph Node Metastasis in Papillary Thyroid Cancer

• Park JH
• Lee KS
• Bae KS
• Kang SJ

• KMID: 2095123
• DOI: http://doi.org/10.11106/cet.2014.7.2.129

Abstract

Papillary thyroid cancer is a common endocrine cancer and commonly presents with lymph node metastases. It has been generally accepted that lymphatic drainage occurs from the thyroid primarily to the central lymphatic compartment and secondarily to the lateral compartment nodes. Recently, improvements in the resolution of imaging studies and the availability of highly sensitive thyroglobulin assays have highlighted the importance of identifying disease in the pre-operative assessment and dealing effectively with metastatic regional disease in order to prevent recurrence. However, there are limitations to diagnosing central lymph node metastases. With unreliable imaging modalities, prophylactic central lymph node dissection should be performed on all patients with papillary thyroid cancer. In comparison with the central compartment, prophylactic lateral node dissection has little or no effect on improving the prognosis of patients with papillary thyroid cancer. Therefore, lateral node dissection is recommended only as a part of the therapeutic procedure. The extension of lateral neck dissection is recommended a comprehensive selective neck dissection of levels IIa, III, IV, and Vb. The rich lymphatic supply of the thyroid gland coupled with the propensity for nodal metastases in papillary thyroid cancer require the modern thyroid surgeon to be familiar with the indications for and techniques of regional lymph node dissection.

Keyword

Papillary thyroid cancer; Lymph node; Metastasis; Central compartment; Lateral neck

MeSH Terms

Drainage
Endocrine Gland Neoplasms
Humans
Lymph Node Excision
Lymph Nodes*
Neck Dissection
Neoplasm Metastasis*
Prognosis
Recurrence
Thyroglobulin
Thyroid Gland
Thyroid Neoplasms*
Thyroglobulin

Figure

• 

  Fig. 1. Nodal levels with corresponding anatomic landmarks.

Reference

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