Enemy Beyond the Wall: Clinicopathological Features of Intrathyroidal Papillary Thyroid Carcinoma (T1-T3a) That Metastasize to Lymph Nodes Without Extrathyroidal Extension

2021 ◽  
pp. 1-8
Author(s):  
Abbas Ali Tam ◽  
Nurcan Ince ◽  
Husniye Baser ◽  
Ayşegul Aksoy Altinboga ◽  
Mehmet Kilic ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Extrathyroidal Extension ◽  
Clinicopathological Features ◽  
Papillary Thyroid

scholarly journals Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Tumor Size ◽  
Frozen Section ◽  
Extrathyroidal Extension ◽  
Capsular Invasion ◽  
Papillary Thyroid

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.

scholarly journals Pretreatment BMI Is Associated with Aggressive Clinicopathological Features of Papillary Thyroid Carcinoma: A Multicenter Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Shi-tong Yu ◽  
Wanzhi Chen ◽  
Qian Cai ◽  
Faya Liang ◽  
Debin Xu ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Recurrent Disease ◽  
Normal Weight ◽  
Extrathyroidal Extension ◽  
Clinicopathological Features ◽  
Tnm Stage ◽  
Teaching Hospitals ◽  
Papillary Thyroid ◽  
Increased Risk

Objectives. The aim of the present study was to analyze the association between pretreatment body mass index (BMI) and the aggressiveness of papillary thyroid carcinoma (PTC) along with its clinical outcomes in a Chinese population with BMI classification for Asians. Methods. A retrospective, observational study was conducted on patients from two teaching hospitals in China. 1622 classical PTC patients were categorized into four groups according to BMI. Results. We found that increased BMI was associated with extrathyroidal extension, multifocality, the presence of lymph node (LN) metastasis, and advancing TNM stage in PTC patients. Furthermore, compared to patients with normal weight, those in the overweight and obese group exhibited a significantly increased risk of extrathyroidal extension, multifocality, cervical LN metastasis, and advanced TNM stage. 40 and 37 patients experienced persistent and recurrent disease, respectively. No differences regarding persistent disease or recurrence were observed among the BMI groups. Conclusion. A higher pretreatment BMI has been strongly associated with aggressive features of PTC according to the BMI classification for Asians. Obesity was not found to be associated with a greater risk of recurrence.

scholarly journals Unnecessity of Routine Dissection of Right Central Lymph Nodes in cN0 Papillary Thyroid Carcinoma Located at the Left Thyroid Lobe

2021 ◽  
Vol 11 ◽  
Author(s):  
Songtao Zhang ◽  
Runfang Zhang ◽  
Chao Wang ◽  
Wenbo Gong ◽  
Chen Zheng ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Left Lobe ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid ◽  
Thyroid Lobe ◽  
Central Lymph ◽  
Left Thyroid Lobe

ObjectiveThe lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) is an important part of the central lymph nodes (LNs). We aimed to explore the rate and predictors of LN-prRLN metastasis in cN0 papillary thyroid carcinoma (PTC) located at the left thyroid lobe.MethodsPatients with surgically treated primary left lobe PTC were retrospectively enrolled. The metastatic distribution of LN-prRLN and postoperative complications were assessed. The association between LN-prRLN metastasis and clinicopathological variables was evaluated by univariate and multivariate analyses.ResultsA total of 857 patients were included for the analysis. Central LN metastasis was noted in 310 (35.3%) cases. The most (27.6%) and least (1.7%) commonly involved LNs were the left paratracheal LN and the LN-prRLN. In the univariate analysis, the tumor size, multifocality, the extent of extrathyroidal extension (none vs. macroscopic vs. macroscopic maximal), and perineural invasion were associated with positive LN-prRLN. In the multivariate analysis, tumor size of &gt;40.0 mm and macroscopic maximal invasion were found as the only two independent predictors. Transient and permanent hypoparathyroidism were noted in 90 (10.2%) and 13 (1.5%) patients, respectively. Voice change was noted in 40 (4.6%) patients, and 20 patients recovered.ConclusionsIn cN0 PTC located at the left lobe, LN-prRLN metastasis was very uncommon. We found that LN-prRLN dissection is not required routinely, but should be performed if the tumor size is &gt;40.0 mm and macroscopic maximal extrathyroidal extension is present.

scholarly journals Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhichao Xing ◽  
Yuxuan Qiu ◽  
Zhe Li ◽  
Lingyun Zhang ◽  
Yuan Fei ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Independent Predictor ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin

Abstract Background To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). Methods This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. Results Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649–267.384; P = 0.019). Conclusion Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.

scholarly journals Papillary Thyroid Carcinoma Arising in Children and Adolescent Hashimoto’s Thyroiditis: Ultrasonographic and Pathologic Findings

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sun Hye Jeong ◽  
Hyun Sook Hong ◽  
Eun Hye Lee ◽  
Jeong Ja Kwak
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Hashimoto’S Thyroiditis ◽  
Extrathyroidal Extension ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Node Metastases

Objectives. We compared the ultrasonography and pathology features of papillary thyroid carcinoma (PTC) in pediatric and adolescents with Hashimoto’s thyroiditis (HT) with those of non-HT patients.Materials and Methods. Eleven patients who were surgically confirmed to have pediatric or adolescent PTC from 2006 to 2014 were included in this study. We retrospectively analyzed the preoperative ultrasonography and pathology features of PTC arising in HT and non-HT patients.Results. On ultrasonography, thyroid gland was lobulated and enlarged, with many scattered microcalcifications in four of five HT patients. Four of six non-HT patients had suspicious masses with calcifications. The diffuse sclerosing variant of PTC (DSVPTC) was found in three of five HT patients, but none in non-HT patients. Macroscopic or microscopic extrathyroidal extension was evident in all of the HT patients and four of the non-HT patients. Neck lymph node metastases were in all HT patients and five of non-HT patients.Conclusions. Three of five PTCs in pediatric and adolescent HT patients were DSVPTC, whereas all PTCs of the non-HT patients were classic type. On ultrasonography, thyroid gland was diffusely enlarged with scattered microcalcifications in four of five HT patients. All five HT cases had aggressive disease, including extrathyroidal extension and cervical lymph node metastases.

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