title: Transoral resection of thyroid cancer metastasis to lateral retropharyngeal nodes.
abstract: BACKGROUND
  Lymph node metastasis from differentiated thyroid carcinoma may occur outside of the basins at greatest risk of spread, such as the lateral retropharyngeal lymph nodes. The extensive surgery of traditional approaches to the retropharyngeal space are rarely justified in the treatment of metastatic differentiated thyroid cancer. Therefore, a less invasive surgical approach is advantageous in resection of metastatic lateral retropharyngeal nodes.
  
  
  METHODS
  To assess feasibility and safety, we report transoral excision guided by preoperative ultrasonography in a series of 3 consecutive patients with differentiated thyroid cancer metastatic to the retropharyngeal space.
  
  
  RESULTS
  In all cases, the metastatic lateral retropharyngeal lymph node was successfully removed by transoral retropharyngotomy without complications.
  
  
  CONCLUSIONS
  We advocate a transoral approach guided by preoperative ultrasonography for resection of differentiated thyroid cancer metastatic to the retropharyngeal lymph nodes. The approach is feasible, minimally invasive, and safe in achieving the goals in management of regionally metastatic disease.
authors.affiliation: Department of Head & Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Shellenberger
authors.forename: Bruno
authors.initials: B
authors.lastname: Fornage
authors.forename: Lawrence
authors.initials: L
authors.lastname: Ginsberg
authors.forename: Gary L
authors.initials: GL
authors.lastname: Clayman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010614:Pharynx; D013964:Thyroid Neoplasms / Q000473:pathology*