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KMID : 0361020180610060312
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Korean Journal of Otolaryngology - Head and Neck Surgery
2018 Volume.61 No. 6 p.312 ~ p.316
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A Case of Papillary Thyroid Carcinoma with Subclinical Lateral Lymph Node Metastasis Presenting as Recurrence
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Kim Hae-Dong
Cho Jae-Keun
Kim Jin-Woo
So Yoon-Kyoung
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Abstract
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Lateral neck metastasis is an independent risk factor of the loco-regional recurrence in papillary thyroid carcinoma (PTC). Ultrasonography (US) and computed tomography are frequently performed to diagnose the lymph node (LN) metastasis. However, some metastatic LNs can remain after initial treatment and can present as regional recurrences. A 19-year-old woman was diagnosed as having 1.99 cm PTC. No abnormal LNs was detected on preoperative CT and US. She underwent operation and radioactive iodine (RAI) therapy: seven months after RAI therapy, thyroglobulin level was elevated. However, no metastatic LNs were detected on neck CT, US and positron emission tomography-CT. Neck exploration was performed and metastatic PTC was diagnosed in bilateral level III and IV. A radiologist retrospectively reviewed the neck CTs taken before the first surgery and the second surgery. There was no significant difference in the LN appearances of two CTs. On both CT scans, all LNs were very small, homogenously enhanced, without calcification or cystic changes.
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KEYWORD
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Adjuvant radiotherapy, Neck dissections, Papillary thyroid carcinoma
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