Preoperative Clinical and Sonographic Predictors for Lateral Cervical Lymph Node Metastases in Sporadic Medullary Thyroid Carcinoma

Thyroid ◽  
2018 ◽  
Vol 28 (3) ◽  
pp. 362-368 ◽  
Author(s):  
Hye-Seon Oh ◽  
Hyemi Kwon ◽  
Eyun Song ◽  
Min Ji Jeon ◽  
Dong Eun Song ◽  
...  
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Sporadic Medullary Thyroid Carcinoma ◽  
Medullary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

scholarly journals Risk Factors for Lateral Lymph Node Metastases in Patients With Sporadic Medullary Thyroid Carcinoma

2020 ◽  
Vol 19 ◽  
pp. 153303382096208
Author(s):  
Xin Wu ◽  
Binglu Li ◽  
Chaoji Zheng ◽  
Wei Liu ◽  
Tao Hong ◽  
...  
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Lateral Neck ◽  
Lateral Neck Dissection ◽  
Lateral Lymph Node ◽  
Sporadic Medullary Thyroid Carcinoma ◽  
Medullary Thyroid ◽  
Node Metastases

Purpose: Medullary thyroid carcinoma is a rare endocrine malignancy; 75% of patients with this disease have sporadic medullary thyroid carcinoma. While surgery is the only curative treatment, the benefit of prophylactic lateral neck dissection is unclear. This study aimed to analyze the clinicopathological risk factors associated with lateral lymph node metastases and determine the indication for prophylactic lateral neck dissection in patients with sporadic medullary thyroid carcinoma. Methods: The medical records of patients with medullary thyroid carcinoma who were treated at our hospital between January 2002 and January 2020 were retrospectively reviewed; a database of their demographic characteristics, test results, and pathological information was constructed. The relationship between lateral lymph node metastases and clinicopathologic sporadic medullary thyroid carcinoma features were analyzed using univariate and multivariate analyses. Results: Overall, 125 patients with sporadic medullary thyroid carcinoma were included; 47.2% and 39.2% had confirmed central and lateral lymph node metastases, respectively. Univariate and multivariate analyses identified 2 independent factors associated with lateral lymph node metastases: positive central lymph node metastases (odds ratio = 9.764, 95% confidence interval: 2.610–36.523; p = 0.001) and positive lateral lymph nodes on ultrasonography (odds ratio = 101.747, 95% confidence interval: 14.666–705.869; p < 0.001). Conclusion: Medullary thyroid carcinoma is a rare endocrine malignancy. Lymph node metastases are common in patients with sporadic medullary thyroid carcinoma. Prophylactic lateral neck dissection is recommended for patients who exhibit positive central lymph node metastases and/or positive lateral lymph nodes on ultrasonography.

Ultrasonographic features of medullary thyroid carcinoma nodules less than 1 cm compare with papillary thyroid microcarcinomas: a retrospective analysis

2019 ◽  
Author(s):  
Xiaoyu Li ◽  
Wei Zhou ◽  
Weiwei Zhan
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Univariate Analysis ◽  
Papillary Thyroid ◽  
Medullary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Round Shape ◽  
Node Metastases

Abstract Objective: The aim of this study was to retrospectively analyze the ultrasonographic characteristics of medullary thyroid carcinomas (MTCs) with size less than 1 cm (MTMCs) compared with those of papillary thyroid microcarcinomas (PTMCs).Materials and Methods: This study included 41 patients with 46 MTMCs between January 2008 to April 2017 and 104 consecutive patients with 136 PTMCs between January to June 2015. All thyroid carcinoma nodules were surgically and histologically proved. Age and nodules size were analyzed by independent sample t test. Sex, multiplicity and cervical lymph node metastases were evaluated by χ2 or Fisher’s exact tests. Univariate analysis and multivariate logistic regression analysis were performed on the sonographic features of thyroid carcinoma nodules, including location, composition, echogenicity, shape, margin, boundary, calcifications and vascularization degree.Results: More MTMCs presented cervical lymph node metastases than PTMCs (36.59% vs 20.19%, p = 0.040). Compared with PTMCs, MTMCs tended to have an ovoid to round shape (P = 0.000, odds ratio [OR], 4.018; 95% CI, 1.295-12.473), more commonly showed solid composition (P = 0.004, OR, 0.13; 95% CI, 0.020-0.842), and macrocalcifications (P = 0.001, OR, 0.085; 95% CI, 0.016-0.454) and hypervascularity (P=0.000, OR, 10.778; 95% CI, 3.939-29.488). There were no significant differences in the location, margin, boundary, echogenicity, peripheral halo ring, the present of calcifications, microcalcifications and between MTMCs and PTMCs. Conclusion: MTMCs have the ultrasonographic features of general malignant nodules, such as hypoechoic or markedly hypoechoic solid lesions with unique characteristics including ovoid to round shape, macrocalcifications and hypervascularity.

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