Cervical Metastases as First Symptom of Thyroid Cancer

Abstract

Among 320 cases of thyroid cancer observed at the National Cancer Institute of Milan, 26 had lymph node metastases at the neck as first symptom. Histological examinations of the cervical lymph nodes revealed 24 differentiated carcinomas, either papillary (16 cases) or follicular (8 cases), one indifferentiated carcinoma and one Hürthle-cell carcinoma. In 17 patients the primary thyroid tumor was found; in two cases the histological examination of the thyroid revealed no malignancy: in one case there was a thyroid adenoma while the other showed no pathological lesions. Seven patients had no histological examination of the thyroid gland. Seventeen cases were surgically treated with emithyroidectomy or total thyroidectomy with en-bloc radical neck dissection. Fifteen out of these cases are well 1 to 8 years after treatment; 2 other cases who had only palliative treatment are surviving 5 and 8 years after therapy. The best prognosis was observed in papillary carcinoma and in female patients.