Korean J Otorhinolaryngol-Head Neck Surg.  2018 Jun;61(6):312-316. 10.3342/kjorl-hns.2016.17447.

Case of Papillary Thyroid Carcinoma with Subclinical Lateral Lymph Node Metastasis Presenting as Recurrence

• Kim HD
• Cho JK
• Kim JW
• So YK

• KMID: 2436474
• DOI: http://doi.org/10.3342/kjorl-hns.2016.17447

Abstract

Lateral neck metastasis is an independent risk factor of the loco-regional recurrence in papillary thyroid carcinoma (PTC). Ultrasonography (US) and computed tomography are frequently performed to diagnose the lymph node (LN) metastasis. However, some metastatic LNs can remain after initial treatment and can present as regional recurrences. A 19-year-old woman was diagnosed as having 1.99 cm PTC. No abnormal LNs was detected on preoperative CT and US. She underwent operation and radioactive iodine (RAI) therapy: seven months after RAI therapy, thyroglobulin level was elevated. However, no metastatic LNs were detected on neck CT, US and positron emission tomography-CT. Neck exploration was performed and metastatic PTC was diagnosed in bilateral level III and IV. A radiologist retrospectively reviewed the neck CTs taken before the first surgery and the second surgery. There was no significant difference in the LN appearances of two CTs. On both CT scans, all LNs were very small, homogenously enhanced, without calcification or cystic changes.

Keyword

Adjuvant radiotherapy; Neck dissections; Papillary thyroid carcinoma

MeSH Terms

Electrons
Female
Humans
Iodine
Lymph Nodes*
Neck
Neck Dissection
Neoplasm Metastasis*
Radiotherapy, Adjuvant
Recurrence*
Retrospective Studies
Risk Factors
Thyroglobulin
Thyroid Gland*
Thyroid Neoplasms*
Tomography, X-Ray Computed
Ultrasonography
Young Adult
Iodine
Thyroglobulin