scholarly journals Risk Factors for Central and Lateral Lymph Node Metastases in Patients With Papillary Thyroid Micro-Carcinoma: Retrospective Analysis on 484 Cases

2021 ◽  
Vol 12 ◽  
Author(s):  
Yijie Huang ◽  
Ying Yin ◽  
Wenyi Zhou
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Metastases ◽  
Papillary Thyroid ◽  
Lateral Lymph Node ◽  
Surgical Interventions ◽  
Node Metastasis ◽  
Potential Risk Factors ◽  
Node Metastases

BackgroundPapillary thyroid micro-carcinoma (PTMC) is defined as a tumor with a larger diameter ≤1 cm which has an indolent course and satisfying prognosis. However, the incidence of lymph node metastasis of PTMC cannot be ignored. The aim of this study was to assess the incidence of lymph node metastasis in PTMC patients, as well as to evaluate the risk factors for both central lymph node metastases (CLNM) and lateral lymph node metastases (LLNM).MethodsPatients who underwent thyroidectomy from January 2017 to October 2020, and pathologically diagnosed with PTMC were enrolled in our study and their medical records were collected and analyzed.ResultsA total of 484 PTMC patients were included. The incidence of central and lateral lymph node metastasis was 49.6% and 9.1%, respectively. Multivariate analysis demonstrated as independent risk factors for CLNM male sex, age <40 years, largest tumor size ≥5 mm and bilaterality. Extrathyroidal extension, presence of CLNM, number of CLNM ≥5 were strong indicators for LLNM.ConclusionThe incidence of lymph node metastases in PTMC is non-negligible. The identification of potential risk factors for CLNM and LLNM would help tailor individual surgical interventions for patients with PTMC.

scholarly journals Risk Factors and a Prediction Model of Lateral Lymph Node Metastasis in CN0 Papillary Thyroid Carcinoma Patients With 1–2 Central Lymph Node Metastases

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuanyuan Wang ◽  
Chang Deng ◽  
Xiujie Shu ◽  
Ping Yu ◽  
Huaqiang Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lateral Lymph Node Metastasis ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
Lateral Lymph Node ◽  
Node Metastasis ◽  
Node Metastases ◽  
Central Lymph

BackgroundPapillary thyroid cancer (PTC) in clinically lymph node-negative (cN0) patients is prone toward lymph node metastasis. As a risk factor for tumor persistence and local recurrence, lateral lymph node metastasis (LLNM) is related to the number of central lymph node metastases (CLNMs).MethodsWe performed LLNM risk stratification based on the number of CLNMs for cN0 PTC patients who underwent thyroidectomy and lymph node dissection between January 2013 and December 2018. A retrospective analysis was applied to the 274 collected patients with 1-2 CLNMs. We examined the clinicopathological characteristics of the patients and constructed a LASSO model.ResultsIn the 1–2 CLNM group, tumors >10 mm located in the upper region and nodular goiters were independent risk factors for LLNM. Specifically, tumors >20 mm and located in the upper region contributed to metastasis risk at level II. Hashimoto’s thyroiditis reduced this risk (p = 0.045, OR = 0.280). Age ≤ 30 years and calcification (microcalcification within thyroid nodules) correlated with LLNM. The LASSO model divided the population into low- (25.74%) and high-risk (57.25%) groups for LLNM, with an AUC of 0.715.ConclusionsFor patients with 1–2 CLNMs, young age, calcification, nodular goiter, tumor >10 mm, and tumor in the upper region should alert clinicians to considering a higher occult LLNM burden. Close follow-up and therapy adjustment may be warranted for high-risk patients.

scholarly journals Aberrant intrathyroidal lymph node metastasis in classical papillary thyroid carcinoma

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Wan Mohd Nazlee Wan Zainon ◽  
Wan Faiziah Wan Abdul Rahman ◽  
Maya Mazuwin Yahya ◽  
Nor Azwani Mat Nawi ◽  
Nurul Shamimi Suhaimi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
High Dose ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Node Metastases

Abstract Background In cases of papillary thyroid carcinoma (PTC), lymph nodes are a typical site of metastasis. Extrathyroidal tissue involvement in differentiated thyroid carcinoma causes the disease to progress and affects the patients’ treatment options. Papillary thyroid carcinoma (PTC) is the common type in differentiated thyroid carcinoma (DTC), the other type is follicular thyroid carcinoma (FTC). Ectopic sites, such as intrathyroidal lymph node invasion in classical papillary thyroid malignancy, are extremely uncommon. It can be difficult to detect an intrathyroidal lymph node (ITLN) during a histopathological test, but it is important to do so since it affects the stage of the disease and subsequent treatment. Case presentation We present the case of a 63-year-old woman who presented with multinodular goitre and underwent total thyroidectomy. She was diagnosed with aberrant intrathyroidal lymph node metastases during pathological testing, resulting in an upgrade in treatment. Owing to the exceptionally unusual ectopic position of lymph node metastasis, in this case, there is a risk of diagnostic and therapeutic misinterpretation. This patient was treated with high-dose radioactive iodine in view of lymph node metastases. Conclusions Identification of ITLN by imaging characteristics is sometimes difficult, being often an intraoperative discovery and histopathological correlation that lead to upstage the disease and alter the final management.

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