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KMID : 1202020080010020136
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Journal of Korean Thyroid Association
2008 Volume.1 No. 2 p.136 ~ p.141
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Clinical Analysis of Occult Papillary Thyroid Carcinoma Presenting as as Lateral Neck Mass
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Lee Jung-Yeol
Park Jae-Hong
Mok Ji-Oh
Koh Eun-Seok
Hong Hyun-Sook
Park Jung-Mi
Koh Youn-Woo
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Abstract
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Background and Objectives: Neck metastasis associated with occult papillary thyroid carcinomas rarely present as a lateral neck mass. This study investigates the incidence, presentation, evaluation, pathologic features, and process for definite treatment of occult papillary thyroid carcinoma presenting with a lateral neck mass.
Materials and Methods: Fifty-nine patients with papillary thyroid carcinoma combined with neck metastasis were enrolled in this study. All patients underwent total thyroidectomy with lateral compartment neck dissection. The occult group consisted of 11 patients. The non-occult group comprised 48 patients.
Results: Mean age in occult group was younger than non-occult group and male was dominant in occult group. We could find the abnormality of thyroid gland only in 3 of 11 (27.3%) by CT and 3 of 3 (100%) by ultrasonograpy. Fine needle aspiration biopsy (FNAB) was found to be helpful in 6 of 10 (60%). All of four false negative results consisted of cystic lesions. Mean primary tumor size was significantly smaller in occult than in non-occult group. No significant difference was observed in the other variables.
Conclusion: Sole presentation as a lateral neck mass, especially in young & male should be considered in the differential diagnosis of occult papillary thyroid carcinoma. FNAB may be a initial diagnostic tool of choice. However, in case of cystic lesion, there are possibility of misleading interpretation of cytology. Although ultrasonography can be a good modality to evaluate occult papillary thyroid carcinoma, various radiologic study could not find primary thyroid focus.
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KEYWORD
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Thyroid, Papillary carcinoma, Occult
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