Lateral neck mass as the initial manifestation of thyroid carcinoma.
Of 238 thyroid cancer patients, 24 exhibited a lateral neck mass as the initial presentation. Twenty four (77.4%) of 31 metastatic masses were located at the midjugular and lower jugular lymph chains. The average number of histologically proven metastatic nodes was 6.5. Histologically, 22 cases were diagnosed as papillary carcinoma, 1 as follicular carcinoma, and the remaining case as medullary carcinoma. Fifteen thyroid glands were found to have a single primary focus, while 9 others had multiple foci. The mean diameter of the primary foci was 1.2 cm. The rates of detection of primary foci by thyroid scan and ultrasonography were 60% and 37.5%, respectively. Surgical procedures for the thyroid lesions included total or near-total thyroidectomy in 18 cases and lobectomy in 6 cases; for metastatic neck nodes, 13 were treated by modified neck dissection, 5 by standard radical neck dissection, and six by partial neck dissection. All 24 patients were followed for a mean duration of 4.5 years with a range of 2.0 to 7.5 years, and all except 1 are still living. In the presence of a lateral neck mass as the initial manifestation of thyroid carcinoma, no matter what size the primary tumor foci, a total or near-total thyroidectomy appears to be justified in addition to an appropriate neck dissection.
Park
C S
CS
Department of Surgery, Yonsei University College of Medicine, Korea.
Min
J S
JS
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology