Introduction: Thyroid microcarcinoma with palpable cervical node metastasis is a rare clinical situation. Through this work, we aim to study its clinical, therapeutic and evolutionary features.
Material and methods: We conducted a retrospective study over 14 cases of thyroid microcarcinoma presenting with a palpable cervical lymph node metastasis collected on the ENT department of Farhat Hached hospital over 28 years (19902017).
Results: The mean age of our patients was 47 years. The Sex-ratio was 0.14. The mean lymph node size was 3 cm. There was no palpable tumor in the thyroid gland in 10 cases. All our patients underwent an exploratory cervicotomy. Histological examination revealed a lymph node metastasis of a thyroid carcinoma (papillary in 13 cases and follicular in 1 case). All our patients had a total thyroidectomy. Twelve patients had a central neck dissection with a lateral dissection in one case. Bilateral lymph node dissection was performed in one case. Thirteen patients had a radioactive iodine treatment. We had no case of death or recurrence. The follow- up period was 58 months.
Conclusion: The diagnosis of cervical lymph node metastases in thyroid microcarcinoma should be considered especially with young patients. Their treatment includes total thyroidectomy, lymph node dissection and complementary radioiodine treatment. Long-term follow up is necessary. Their prognosis remains excellent.
18 - 21 May 2019
European Society of Endocrinology