Lymphatic drainage, regional metastases and surgical management of papillary thyroid carcinoma arising in pyramidal lobe--a single institution experience.
Papillary thyroid carcinoma (PTC) arising in pyramidal lobe (PL) is very rare. The aim of this study was to determine the incidence of single PTC focus in PL and its lymphonodal metastases, as well as to present a single surgeon experience in management of PL PTC. We performed a retrospective analysis of records of all patients surgically treated for PTC in our institution from year 2003 to 2013. Only patients with single PTC focus in PL were included. Out of total 753 patients, majority (66.52%) had PTC focus in one of the lobes, while only 3 patients (0.4%) had solitary PTC focus in PL. They were all females, aged 36, 41 and 22. During surgery, methylene-blue dye was injected peritumorally. After frozen section analysis of excised PL and isthmus and confirmation of malignancy, we performed total thyroidectomy with central neck dissection, as well as sentinel lymph node biopsy in both jugulo-carotid regions. Pathology showed encapsulated PTC stage T1 and solitary metastasis in Delphian lymph node of the youngest patient. All patients were disease free in the follow-up. PTC single focus in PL is very rare and only individual experiences can be discussed regarding the extent of the surgery.
Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, National Cancer Research Center, Belgrade 11000, Serbia.
Nada
N
Santrac
Nikola
N
Besic
Marko
M
Buta
Merima
M
Oruci
Igor
I
Djurisic
Gordana
G
Pupic
Ljubica
L
Petrovic
Yasuhiro
Y
Ito
Radan
R
Dzodic
D000328:Adult; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D037981:Neck Dissection; D009362:Neoplasm Metastasis / Q000473:pathology*; D011712:Pyramidal Tracts; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D055771:Serbia; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome