scholarly journals Internal Spreading of Papillary Thyroid Carcinoma: A Case Report and Systemic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hui Jin ◽  
Huanhuan Yan ◽  
Huamei Tang ◽  
Miao Zheng ◽  
Chaojie Wu ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Frozen Section ◽  
Large Diameter ◽  
Systemic Review ◽  
Papillary Thyroid ◽  
Intraoperative Frozen Section ◽  
Central Lesion ◽  
Preoperative Ct ◽  
Poorly Differentiated

An 18-year-old female diagnosed finally as PTC with intrathyroid spread was reported, and the diagnosis and surgical treatment of internal spreading of PTC were discussed. One lump was found on the thyroid isthmus by physical examination and B ultrasound, and multiple nodular shadows were found by CT. This patient finally underwent total thyroidectomy with bilateral central node dissection due to multifocal papillary thyroid carcinoma except PTC in the isthmus found in right lobe by intraoperative frozen section. The pathological section showed a major thyroid carcinoma in thyroid isthmus with scattered micropapillary carcinoma around it in the whole thyroid gland. The small lesions are distributed around central lesion in a radial form and the number of small lesions decreases with increased distance from central lesion. PTC with internal spread should be distinguished from multifocal PTC and poorly differentiated PTC in pathology. Thyroid cancerous node had a large diameter; it was likely to have internal spread. Combined imaging before surgery should be valued to diagnose PTC with internal spread. Preoperative CT and intraoperative frozen section are helpful for surgical volume selection of PTC with internal spread.

scholarly journals Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Tumor Size ◽  
Frozen Section ◽  
Extrathyroidal Extension ◽  
Capsular Invasion ◽  
Papillary Thyroid

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.

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