Lymph node metastasis around the entrance point to recurrent laryngeal nerve in papillary thyroid carcinoma
Abstract Background There were few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN) in patients with papillary thyroid carcinoma (PTC). Therefore, we aimed to increase awareness of LN-epRLN. Methods A prospective analysis including 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was performed. We explored the surrounding tissue of entrance point to recurrent laryngeal nerve, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination, and the complications and follow-ups were recorded. Results LN-epRLN was found in 73 of the 878 patients and the metastasis rate was 3.76%. In univariate analysis, LN-epRLN metastasis was correlated with further central nodal metastasis, tumor location in the upper third of the thyroid and tumor multifocality. Conclusions LN-epRLN can be the site of metastasis of PTC. CLND scope should include the surrounding tissue of entrance point to recurrent laryngeal nerve. LN-epRLN metastasis in PTC is associated with tumor location in the isthmus or upper third of the thyroid, tumor multifocality and further central nodal metastasis.