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A papillary thyroid microcarcinoma (PTMC) is defined by the World Health Organization as a carcinoma measured at 1.0 cm or less in its greatest dimension (1). There is an increase in the proportion of PTMC identified among all differentiated thyroid carcinomas mainly due to the improvement and increased in use of ultrasound (US) examination, fine-needle aspiration biopsy, and other diagnostic procedures (2). It is estimated that PTMC accounts for up to 30% of all papillary thyroid cancers, although marked geographic differences in incidence rates have been noted (3). In South Korea, PTMC was reported in up to 50.2% of thyroid carcinomas (4). Currently, there is controversy on the extent of surgery necessary for PTMC. In published clinical guidelines of organizations including the American Thyroid Association, the National Comprehensive Cancer Network, and the British Thyroid Association, the general recommendation in cases of lymphadenopathy is to perform lymph node dissection of the affected compartments. In patients with biopsy-proven metastatic lateral cervical lymphadenopathy, therapeutic lateral neck compartmental lymph node dissection was recommended with total thyroidectomy (TT) to provide clearance of disease (5-8). Patients with preoperatively detected lateral neck node metastasis are more likely to develop recurrence in the lymph nodes (9). Thus, preoperative US examination is important for evaluating lateral metastatic lymph nodes to determine the exOriginal Article

Ultrasonographic Features of Metastatic Lymph Nodes in Papillary Thyroid Microcarcinomas and Macrocarcinomas