title: [Isolated cystic cervical lymphatic metastasis from occult papillary carcinoma of the thyroid: unusual and rather difficult diagnosis].
abstract: Thyroid papillary carcinoma, exceptionally, can appear with cervico-lateral metastases in absence of thyroid evident disease. In that case we can have an infected branchial cyst, therefore is very important a correct preoperative diagnosis with FNAB. In literature were described 30 cases of cervico-lateral cystic masses that the histology revealed as occult papillary carcinoma metastases. Our experience is about 80 cases of papillary carcinoma, in only 2 cases the cancer was evident as a tight-elastic tumour in cervico-lateral region, hypoechogenic to the US scan with irregular and thick wall: one of the patient had multinodular goiter; the other one didn't have clinical of US scan character of thyroid disease. FNAB on lymph nodes shows doubtful cells evidence. Both patient had a total thyroidectomy with functional cervico-lateral and MAS lymphadenectomy. In one patient histology showed a papillary carcinoma of 4 mm in the right lobe, in the other patient the cancer was unknown. FNAB, in all doubtful cases, is the most important diagnosis test.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università degli Studi G. D'Annunzio di Chieti.
authors.forename: F
authors.initials: F
authors.lastname: Francomano
authors.forename: R
authors.initials: R
authors.lastname: Cotellese
authors.forename: T
authors.initials: T
authors.lastname: Francione
authors.forename: A
authors.initials: A
authors.lastname: Dell'osa
authors.forename: L
authors.initials: L
authors.lastname: Napolitano
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000556:secondary*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary; D013964:Thyroid Neoplasms / Q000473:pathology*