Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report.
Abstract: Thyroid papillary microcarcinoma is defined as that which measures 10 mm. or less in its widest diameter. This lesion is considered to have an excellent prognosis, generally following a benign course. However, they may occasionally exhibit aggresive behaviour in the form of lymph...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/35007 |
| Aporte de: |
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I10-R327-article-35007 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
thyroid carcinoma, papillary lymphatic metastasis thyroid cancer carcinoma papilar de tiroides metástasis en los ganglios linfáticos cáncer de tiroides |
| spellingShingle |
thyroid carcinoma, papillary lymphatic metastasis thyroid cancer carcinoma papilar de tiroides metástasis en los ganglios linfáticos cáncer de tiroides Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| topic_facet |
thyroid carcinoma, papillary lymphatic metastasis thyroid cancer carcinoma papilar de tiroides metástasis en los ganglios linfáticos cáncer de tiroides |
| author |
Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C |
| author_facet |
Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C |
| author_sort |
Perez , C |
| title |
Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| title_short |
Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| title_full |
Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| title_fullStr |
Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| title_full_unstemmed |
Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| title_sort |
cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. |
| description |
Abstract:
Thyroid papillary microcarcinoma is defined as that which measures 10 mm. or less in its widest diameter. This lesion is considered to have an excellent prognosis, generally following a benign course. However, they may occasionally exhibit aggresive behaviour in the form of lymphatic metastasis based on a number of predictive factors, namely bilaterality, age below 50 years, size over 5.75 mm., extrathyroidal extension and lymphovascular invasion. The ideal diagnostic approach includes, among others, clinical suspicion, ultrasound, fine needle aspiration and eventual surgery to confirm the diagnosis.
The objective is to report the case of a thyroid papillary microcarcinoma diagnosed after having metastasized to cervical lymph nodes and the serial sectioning with thorough examination of the thyroidectomy specimen, following diagnostic procedures that evidenced no abnormalities, thus hindering the early study and suspicion of a primary origin in the thyroid gland, prompting instead the presumptive diagnosis of other entities such as hematolymphoid neoplasms, for which the use of fine needle aspiration as the initial method of diagnosis is controversial.
A 53 year old male patient presented with right laterocervical lymphadenopathies. A toracoabdominal computerized tomography (CT) scan was performed, along with a laringoscopy and thyroid ultrasound, all of which revealed no unusual findings. The laterocervical lymph node conglomerate was then surgically resected, its intraoperative examination resulting in the diagnosis of carcinoma with histological features suggestive of a primary origin in the thyroid gland, and TTF-1 staining was positive. After the thyroidectomy and subsequent serial sectioning and examination of the specimen in its entirety only 2 foci of papillary microcarcinoma were identified, one in each lobe and both below 2 mm. in size.
In conclusion, it is therefore markedly important to consider a primary origin in the thyroid gland when faced with lymphadenopathies suspicious for malignancy, even when the imaging and clinical findings are inconclusive, whether due to being operator dependent or having low sensitivity when it comes to microcarcinomas. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/35007 |
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I10-R327-article-350072024-04-15T16:19:09Z Cervical lymph node metastasis from thyroid papillary microcarcinoma: a case report. Metástasis ganglionar cervical de microcarcinoma papilar de tiroides: presentación de un caso Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C thyroid carcinoma, papillary lymphatic metastasis thyroid cancer carcinoma papilar de tiroides metástasis en los ganglios linfáticos cáncer de tiroides Abstract: Thyroid papillary microcarcinoma is defined as that which measures 10 mm. or less in its widest diameter. This lesion is considered to have an excellent prognosis, generally following a benign course. However, they may occasionally exhibit aggresive behaviour in the form of lymphatic metastasis based on a number of predictive factors, namely bilaterality, age below 50 years, size over 5.75 mm., extrathyroidal extension and lymphovascular invasion. The ideal diagnostic approach includes, among others, clinical suspicion, ultrasound, fine needle aspiration and eventual surgery to confirm the diagnosis. The objective is to report the case of a thyroid papillary microcarcinoma diagnosed after having metastasized to cervical lymph nodes and the serial sectioning with thorough examination of the thyroidectomy specimen, following diagnostic procedures that evidenced no abnormalities, thus hindering the early study and suspicion of a primary origin in the thyroid gland, prompting instead the presumptive diagnosis of other entities such as hematolymphoid neoplasms, for which the use of fine needle aspiration as the initial method of diagnosis is controversial. A 53 year old male patient presented with right laterocervical lymphadenopathies. A toracoabdominal computerized tomography (CT) scan was performed, along with a laringoscopy and thyroid ultrasound, all of which revealed no unusual findings. The laterocervical lymph node conglomerate was then surgically resected, its intraoperative examination resulting in the diagnosis of carcinoma with histological features suggestive of a primary origin in the thyroid gland, and TTF-1 staining was positive. After the thyroidectomy and subsequent serial sectioning and examination of the specimen in its entirety only 2 foci of papillary microcarcinoma were identified, one in each lobe and both below 2 mm. in size. In conclusion, it is therefore markedly important to consider a primary origin in the thyroid gland when faced with lymphadenopathies suspicious for malignancy, even when the imaging and clinical findings are inconclusive, whether due to being operator dependent or having low sensitivity when it comes to microcarcinomas. Resumen: Se denomina microcarcinoma papilar de tiroides a aquél que mide 10 mm. o menos en su diámetro mayor. Esta neoplasia se considera de excelente pronóstico, siguiendo en general un curso indolente, pero que ocasionalmente puede comportarse de manera agresiva, con metástasis ganglionares según la presencia de distintos factores predictivos, como bilateralidad, edad menor a 50 años, tamaño mayor a 5.75 mm., extensión extratiroidea y permeaciones linfovasculares. La secuencia ideal de métodos diagnósticos son entre otros, la sospecha clínica, ecografía, punción con aguja fina y eventual cirugía confirmatoria. El objetivo es presentar un caso de microcarcinoma papilar de tiroides diagnosticado tras el desarrollo de metástasis ganglionar cervical y estudio seriado de la pieza de tiroidectomía, tras la negatividad de los estudios clínicos e imagenológicos que despistaron la investigación y sospecha de lesión primaria tiroidea, propiciando inicialmente un diagnóstico presuntivo de otras entidades, tales como neoplasias hematológicas, para el diagnóstico de las cuales es controvertido el uso de punción con aguja fina como método de estudio inicial. Se reporta el caso de un paciente de sexo masculino, de 53 años de edad, que presentó adenopatías laterocervicales derechas. Se realizó una Tomografía Computada toracoabdominal, una laringoscoscopía y ecografia tiroidea (en dos oportunidades) sin hallazgos a destacar. Se realizó la resección quirúrgica y estudio intraoperatorio del conglomerado ganglionar laterocervical que resultó diagnostico de carcinoma con características histológicas compatibles con orígen primario tiroideo y se solicitó inmunomarcación para TTF-1, la cual fue positiva. Tras la cirugía y estudio seriado de toda la glándula, se observaron sólo dos focos de microcarcinoma papilar en sendos lóbulos tiroides, de tamaño menor a 2 mm. cada uno. Podemos concluir que es importante barajar un orígen tiroideo de adenomegalias sospechosas de malignidad aún cuando los hallazgos clínicos e imagenológicos no sean concluyentes por ser éstos operador dependientes o poco sensibles en el caso de los microcarcinomas. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/35007 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |