Endocrine Abstracts

Introduction: Routine central lymph node dissection (CLND) in papillary thyroid carcinoma (PTC) is controversial. Selective biopsy of the sentinel lymph node (SLN) could improve the surgical approach, as negative cases would benefit from avoiding a more aggressive technique and in positive samples a more accurate staging would be obtained.

Aim: To analyze the usefulness of SLN biopsy in the surgical treatment of PTC.

Patients and Methods: 21 women and 4 men with diagnosed or suspected PTC were selected for the study. The day before surgery lymphoscintigraphy with intratumoral injection (99mTc-nanocolloid, 4 mCi, ultrasound-guided punction) was performed to obtain planar and SPECT-CT images 2–4 hours after injection. Localized SLN was biopsed with gammaprobe localization. They all underwent a total thyroidectomy and a CLND. Lateral LND was performed in the cases diagnosed as preoperative stage N1b and when a SLN was found in the lateral compartment.

Results: One case showed no drainage in lymphoscintigraphy. Nine cases (36%) had a negative biopsy for both SLN and CLND. Fourteen cases (56%) had a lateral drainage and in 4 of them (28.5%) a metastatic SLN involvement was detected.

One negative SLN was reported to have micrometastases in the final biopsy.: The sensitivity of SLN biopsy was 95%.

Conclusions: SLN biopsy could be useful in staging and in surgical approach of PTC. CLND could be avoided when no SLN involvement was found and a lateral LND would be indicated in lateral SLN affected cases.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.