title: Parapharyngeal metastases from thyroid cancer: surgical management of two cases with minimally-invasive video-assisted technique.
abstract: Metastases to parapharyngeal or retropharyngeal lymph nodes are rare in well-differentiated thyroid cancers. A review of English literature found only 112 cases reported in the last two decades, with an incidence of parapharyngeal lymph nodes metastases ranging from 0.43 to 2.5%. Surgical resection is the most effective treatment for patients with parapharyngeal lymph node metastasis from thyroid carcinoma. We describe two cases of thyroid cancer parapharyngeal lymph node metastases that were surgically removed using a traditional transcervical approach, with the help of a minimally-invasive video-assisted technique. A video-assisted minimally-invasive transcervical approach is a new technique for excision of sizable benign tumours and selected malignant tumours. The endoscopic technique allows clear identification of critical surgical landmarks that guide the dissection through the correct cleavage plane in a nearly bloodless surgical field, thus decreasing the rate of complications. In both patients postoperative follow-up showed no sequelae and recurrence after 20 and 15 months from surgery.
authors.affiliation: Otorhinolaryngology Unit, Head and Neck Department, "San Raffaele" Hospital and Vita-Salute University, Milano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Otorhinolaryngology Unit, Head and Neck Department, "San Raffaele" Hospital and Vita-Salute University, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pilolli
authors.affiliation: Otorhinolaryngology Unit, Head and Neck Department, "San Raffaele" Hospital and Vita-Salute University, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Toma
authors.affiliation: Otorhinolaryngology Unit, Head and Neck Department, "San Raffaele" Hospital and Vita-Salute University, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bussi
mesh_terms: D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000473:pathology*; D013965:Thyroidectomy
keywords: Parapharyngeal space metastases; Thyroid cancer; Video-assisted transcervical approach
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