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Significance and management of thyroid lesions in lymph nodes as an incidental finding during neck dissection
Author(s) -
Fliegelman Lawrence J.,
Genden Eric M.,
Brandwein Margaret,
Mechanick Jeffrey,
Urken Mark L.
Publication year - 2001
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.1128
Subject(s) - medicine , neck dissection , lymph node , dissection (medical) , lymph , thyroid , pathological , radiology , thyroid carcinoma , thyroid cancer , primary tumor , thyroidectomy , general surgery , carcinoma , head and neck , cancer , surgery , pathology , metastasis
Background The incidental discovery of thyroid lesions in lymph nodes during a lymph node dissection performed for a separate primary head and neck tumor is an unusual clinical entity. Its discovery has led to controversy regarding its significance and management. Methods We identified five patients over the years 1991–1999 with this finding. All five patients were subsequently treated with a total thyroidectomy and a level VI lymph node dissection. Results Pathological examination revealed three papillary carcinomas and level VI lymph node metastases in the two patients who had carcinoma in their thyroid glands. All five patients are presently free of their primary and thyroid disease on follow‐up examinations. Conclusions These patients should be addressed with additional work‐up and surgery if metastatic thyroid cancer is documented in the lymph node. We offer a diagnostic algorithm that may aid in further work‐up and treatment in these unusual cases. © 2001 John Wiley & Sons, Inc. Head Neck 23: 885–891, 2001.