title: Axillary lymph nodes metastasis in a patient with recurrent papillary thyroid cancer: a case report.
abstract: BACKGROUND
  Thyroid cancer is the most common endocrine malignancy; the most common type of thyroid cancer is papillary thyroid cancer which accounts for approximately 90% of all thyroid cancers. Previously defined prognostic factors of papillary thyroid cancer include age, gender, tumor size, extrathyroidal extension, and distant metastasis. Cervical lymph node metastases are very common in patients with papillary thyroid cancer. Although papillary thyroid cancer has an excellent prognosis, lymphatic spread is associated with an increased risk of locoregional recurrence. Axillary metastasis is not a common finding in the classic type of papillary carcinoma; hence, a limited number of case reports have described the exceptional and rare metastatic spread of papillary thyroid carcinomas to the axilla.
  
  
  METHODS
  We report a case of metastatic axillary lymphadenopathy in a 61-year-old Egyptian man with a recurrent papillary thyroid cancer. He had a history of total thyroidectomy with right radical neck dissection 18 months ago. He presented to our cancer clinic at the Oncology Centre -Mansoura University with recurrent mass at the right lower parotid region, left cervical lymphadenopathy and left axillary lymphadenopathy. Removal of the recurrent right intraparotid mass, left comprehensive neck dissection and left axillary dissection were performed and the postoperative pathology report showed infiltration of the cervical and axillary lymph nodes by metastatic papillary thyroid cancer.
  
  
  CONCLUSIONS
  Axillary lymph node enlargement in a patient with papillary thyroid cancer should be considered metastatic from thyroid until proved otherwise. Careful thorough examination of patients with recurrent thyroid cancer is essential to address any unusual metastasis.
authors: Surgical Oncology Unit, Oncology Center - Mansoura University, Mansoura, Egypt. mthafez@yahoo.com.
authors: Mohamed T
authors: MT
authors: Hafez
authors: Surgical Oncology Unit, Oncology Center - Mansoura University, Mansoura, Egypt. dr.basel@hotmail.com.
authors: Basel
authors: B
authors: Refky
authors: Surgical Oncology Unit, Oncology Center - Mansoura University, Mansoura, Egypt. khaled14eg@hotmail.com.
authors: Khaled Abd
authors: KA
authors: Elwahab
authors: Pathology Department, Mansoura Faculty of Medicine, Mansoura, Egypt. marafa8@yahoo.com.
authors: Mohammad
authors: M
authors: Arafa
authors: Surgical Oncology Unit, Oncology Center - Mansoura University, Mansoura, Egypt. islamabdouu2010@yahoo.com.
authors: Islam
authors: I
authors: Abdou
authors: Surgical Oncology Unit, Oncology Center - Mansoura University, Mansoura, Egypt. waleedelnahas@yahoo.com.
authors: Waleed
authors: W
authors: Elnahas
mesh_terms: D001365:Axilla; D002277:Carcinoma / Q000150:complications* / Q000473:pathology*; D002291:Carcinoma, Papillary; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000150:complications* / Q000473:pathology*; D014057:Tomography, X-Ray Computed