scholarly journals Hook Needle-Guided Excision of Recurrent Differentiated Thyroid Cancer in Previously Operated Neck Compartments: A Safe Technique for Small, Nonpalpable Recurrent Disease

2006 ◽  
Vol 91 (12) ◽  
pp. 4943-4947 ◽  
Author(s):  
Frederic Triponez ◽  
Liina Poder ◽  
Rasa Zarnegar ◽  
Ruth Goldstein ◽  
Kayvan Roayaie ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Recurrent Disease ◽  
Surgical Complication ◽  
Surgical Excision ◽  
Recurrent Nerve ◽  
Cervical Lymph Nodes ◽  
Recurrent Nerve Palsy ◽  
Number Of Patients ◽  
Recurrent Thyroid Cancer

Abstract Context: As a result of more sensitive techniques to detect recurrent thyroid cancer, the number of patients presenting with small, nonpalpable recurrent thyroid cancer in cervical lymph nodes is increasing. Surgical excision of nonpalpable recurrent thyroid cancer can be difficult, particularly in a previously operated area. Objective: The objective of this study was to investigate whether preoperative insertion of a hook needle under ultrasound guidance is useful in neck reoperations for recurrent thyroid cancer. Patients: Ten consecutive patients presenting over a 4-month period with nonpalpable, ultrasound-visible, fine needle biopsy-proven recurrent thyroid cancer in previously operated neck compartment(s) were studied. Main Outcome Measures: We measured whether it was technically possible to insert a hook needle preoperatively, rate of negative neck exploration, and complication rate. Results: The hook needle was inserted in seven patients. In three patients, the hook needle was not inserted; one patient had palpable disease 4 months after the preoperative clinic visit, one patient had a tumor too close to the carotid artery, and one patient had multiple bilateral foci of recurrent disease in the central neck. One patient had bleeding after insertion of the needle due to a penetration of an anterior jugular vein that was easily managed at neck reexploration. No other complication occurred during the hook needle insertion, and the only surgical complication was a transient recurrent nerve palsy. All pathology reports showed malignant disease. Conclusion: Hook needle-guided excision of recurrent thyroid cancer is feasible and appears to be a promising tool for safe and successful reoperation of patients with small recurrent thyroid cancer in cervical lymph nodes.

scholarly journals Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer

2013 ◽  
Vol 5 (2) ◽  
pp. 45-49
Author(s):  
Ian C Bennett ◽  
Magdalena Biggar ◽  
Clement Wong ◽  
Michael Law
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Intraoperative Ultrasound ◽  
Surgical Excision ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes ◽  
Intraoperative Localization

ABSTRACT As a result of sensitive thyroglobulin assays and widespread use of cervical ultrasound, endocrine surgeons are encountering patients with impalpable suspicious or frankly metastatic cervical lymph nodes in the follow-up phase after treatment for welldifferentiated thyroid cancer. The surgical excision of impalpable disease of recurrent or persistent thyroid cancer can represent a significant challenge which may require some means of intraoperative localization to ensure that affected nodes are removed. Surgeon-performed intraoperative ultrasound (IOUS) can be used for guiding excision of suspicious but impalpable cervical nodes. The IOUS-guided excision technique is described. The successful application of IOUS to localize and guide resection of impalpable nodal recurrences of papillary thyroid carcinoma in two patients is reported. The utilization of IOUS to guide resection of impalpable pathological nodes in the context of thyroid carcinoma is a safe and practical technique which avoids the need for additional localization procedures and unnecessary potential morbidity for the patient. How to cite this article Biggar M, Wong C, Law M, Bennett IC. Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer. World J Endoc Surg 2013;5(2):45-49.

Ultrasonographic Evaluation of Cervical Lymph Nodes in Thyroid Cancer

2016 ◽  
Vol 156 (2) ◽  
pp. 263-271 ◽  
Author(s):  
Maria Regina Marrocos Machado ◽  
Marcos Roberto Tavares ◽  
Carlos Alberto Buchpiguel ◽  
Maria Cristina Chammas
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Cervical Lymph Nodes

scholarly journals Thyroglobulin measurements in washout of fine needle aspirates in cervical lymph nodes for detection of papillary thyroid cancer metastases

2010 ◽  
Vol 54 (6) ◽  
pp. 550-554 ◽  
Author(s):  
André B. Zanella ◽  
Erika L. Souza Meyer ◽  
Letícia Balzan ◽  
Antônio C. Silva ◽  
Joíza Camargo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Cancer Metastases ◽  
Thyroid Cancer Metastases

OBJECTIVE: The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases. SUBJECTS AND METHODS: Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg. RESULTS: The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2). CONCLUSION: The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.

scholarly journals Ptimary thyroid lymphomas and other rare thyroid tumors

2003 ◽  
Vol 50 (3) ◽  
pp. 141-146 ◽  
Author(s):  
Aleksandar Diklic ◽  
Vladan Zivaljevic ◽  
Ivan Paunovic ◽  
Ksenija Krgovic ◽  
Rastko Zivic ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Residual Tumor ◽  
Hashimoto Thyroiditis ◽  
Local Relapse ◽  
Thyroid Tumor ◽  
Recurrent Nerve ◽  
Thyroid Tumors ◽  
Treatment Frequency ◽  
Recurrent Nerve Palsy

Primary thyroid lymphomas are rare. Surgery is seldom indicated. The aim of the study is to find out the main characteristics of primary thyroid lymphomas in our patients, indications for surgery and the possibility of treatment, frequency and characteristics of rare thyroid tumors. Method: retrospective study of 1044 patient operated for malignant thyroid tumor. Results: From 1995 to may 2003, we operated upon 15 patients with primary thyroid lymphomas, 2 men and 13 women mean age of 50.12 years (from 22 to 74 years), also one patient of age 69 with insular thyroid cancer. Reason for surgery was thyroid tumor in all, compressive disturbances in 9, among them 4 with asphyxia. Radical total thyroidectomy was performed in 4 (26.7%), whole in others some residual tumor tissue was could not be removed in spite of thyroidectomy in 3, hemithyroidectomy in 2, tumor debulking in 5 and only open biopsy was performed in one patient. There was no operative mortality, no postoperative hypocalcaemia and no recurrent nerve palsy. Histological type of tumor was Non-Hodgkin lymphoma in 13 patients, Hodgkin disease in 2 female patients of age 22 and 24. Hashimoto thyroiditis was present in 3 patients. After surgery, 13 patients were treated with chemotherapy, one patient died one month after the operation and one patient refused chemotherapy. Follow-up data are available for 9 patients and the mean follow-up period was 20 months (1-48months). Three patients died after a month, 2 and 3 years after surgery. Six patients are without local relapse. In one patient who refused chemotherapy, a year after thyroid surgery, resection of large intestine was performed because of lymphoma of the colon. Conclusion: Malignant thyroid lymphomas are rare. They present with rapidly growing thyroid tumor, compression and asphyxia. Surgery is only temporarily effective and it is necessary to start with chemo-radiotherapy as soon as possible. Rare forms of thyroid cancer have to be histological recognized in order to choose the best way of treatment.

Imaging of Cervical Lymph Nodes in Thyroid Cancer

2021 ◽  
Vol 31 (3) ◽  
pp. 313-326
Author(s):  
Noah Nathan Chasen ◽  
Jennifer Rui Wang ◽  
Qiong Gan ◽  
Salmaan Ahmed
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Cervical Lymph Nodes

scholarly journals The association between tumor’s location and cervical lymph nodes metastasis in papillary thyroid cancer

Gland Surgery ◽  
2019 ◽  
Vol 8 (5) ◽  
pp. 557-568 ◽  
Author(s):  
Ting-Ting Zhang ◽  
Xiu-Zhu Qi ◽  
Jian-Ping Chen ◽  
Rong-Liang Shi ◽  
Shi-Shuai Wen ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Lymph Nodes Metastasis

scholarly journals Outcome of Cervical Lymph Nodes Dissection for Thyroid Cancer with Nodal Metastases: A Southeast Asian 3-Year Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Raymond Z. M. Lim ◽  
Juin Y. Ooi ◽  
Jih H. Tan ◽  
Henry C. L. Tan ◽  
Seniyah M. Sikin
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Neck Dissection ◽  
Lymph Node Dissection ◽  
Endocrine Surgery ◽  
Node Dissection ◽  
Referral Centre ◽  
Local Data ◽  
Cervical Lymph Nodes

Introduction. Therapeutic nodal dissection is still the mainstay of treatment for patients with lymph node metastases in many centres. The local data, however, on the outcome of therapeutic LND remains limited. Hence, this study aims to inform practice by presenting the outcomes of LND for thyroid cancer patients and our experience in a tertiary referral centre.Methods. This is a single-centre retrospective observational study in a Malaysian tertiary endocrine surgery referral centre. Patients who underwent total thyroidectomy with lymph node dissection between years 2013 and 2015 were included and electronic medical records over a 3-year follow-up period were reviewed. The outcomes of different lymph node dissection (LND), including central neck dissection, lateral neck dissection, or both, were compared.Results. Of the 43 subjects included, 28 (65.1%) had Stage IV cancer. Among the 43 subjects included, 8 underwent central LND, and 15 had lateral LND while the remaining 20 had dissection of both lateral and central lymph nodes. Locoregional recurrence was found in 16 (37.2%) of our subjects included, with no statistical difference between the central (2/8), lateral (7/15), and both (7/20). Postoperative hypocalcaemia occurred in 7 (16.3%) patients, and vocal cord palsy occurred in 5 (11.6%), whereas 9 patients (20.9%) required reoperation. Death occurred in 4 of our patients.Conclusion. High recurrence and reoperative rates were observed in our centre. While the routine prophylactic LND remains controversial, high risk patients may be considered for prophylactic LND. The long-term risk and benefit of prophylactic LND with individualised patient selection in the local setting deserve further studies.

scholarly journals Elastography as a Potential Modality for Screening Cervical Lymph Nodes in Patients with Papillary Thyroid Cancer: A Review of Literature

2018 ◽  
Vol 97 (1-2) ◽  
pp. 31-39 ◽  
Author(s):  
Robert Saadi ◽  
Salvatore LaRusso ◽  
Kanupriya Vijay ◽  
David Goldenberg
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Clinical Utility ◽  
Lymph Node Involvement ◽  
Papillary Thyroid ◽  
Ultrasound Technique ◽  
Cervical Lymph Nodes ◽  
Specific Patient ◽  
Clinical Criteria

Papillary thyroid cancer often presents with cervical lymph node involvement and has a high incidence of recurrence, which requires routine follow-up with ultrasound imaging. Elastography is a novel ultrasound technique that has been demonstrated to be effective clinically in detecting tissue pathology in areas such as the liver and breast. Preliminary data suggest that it may be effective in screening tissues in the neck for malignancy, specifically cervical lymph nodes. However, diagnostic criteria and elastographic techniques vary significantly among the studies we have reviewed, which all tend to focus on populations of patients with many different types of primary malignancies. Further research is required on the feasibility of creating standardized and reproducible clinical criteria in a specific patient population. To study the clinical utility of elastography in cervical lymph nodes, patients with diagnosed papillary thyroid carcinoma may serve as an ideal population because of their need for ultrasound surveillance and the propensity of papillary thyroid cancer to metastasize to and recur in cervical lymph nodes. We will review the limitations, techniques, and reported clinical utility of elastography on cervical lymph nodes and its potential as a screening modality for papillary thyroid cancer.

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