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Management of Cervical Lymph Nodes in Differentiated Thyroid Cancer

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Practical Management of Thyroid Cancer

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Abstract

The majority of patients with differentiated thyroid cancer (DTC) have papillary carcinoma (PTC) (85%). These DTCs arise from thyroid follicular epithelial cells. The remaining 15% of DTCs are made up of follicular type (12%), including conventional and oncocytic (Hürthle cell) carcinomas and poorly differentiated tumours (<3%) [1]. Metastases to the regional cervical lymph nodes are relatively common and occur early on. Regional lymph node metastases can be present at the time of diagnosis in the majority of patients with papillary carcinomas and a lesser proportion of patients with follicular carcinomas [2–4]. It has been reported that the incidence of involved cervical lymph nodes in papillary carcinoma is between 20 and 50%, and up to 90% have occult disease [5–12] and it may be present even when the primary tumour is small and intrathyroidal [13]. Compared with adults, children present more often with lymph node and/or disseminated lung disease [14]. Approximately 5–20% of patients develop local or regional recurrence that require further treatments and 10–15% go on to develop distant metastases [15].

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Authors and Affiliations

  1. Department of Head and Neck, ENT Surgery, St. George’s Hospital, London, UK

    Hiro Ishii & Dae S. Kim

  2. Department of Surgery, Great Ormond Street Hospital, London, UK

    John C. Watkinson

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  1. Consultant (Hon), Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK

    Ujjal K. Mallick

  2. London, UK

    Clive Harmer

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Ishii, H., Kim, D.S., Watkinson, J.C. (2018). Management of Cervical Lymph Nodes in Differentiated Thyroid Cancer. In: Mallick, U.K., Harmer, C. (eds) Practical Management of Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-91725-2_8

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