ECE2024 Eposter Presentations Thyroid (198 abstracts)
Deep cervical lymph node metastasis of thyroid cancer: a case report
Houas Jihene 1 , Heyfa Belhadj-Miled 1 , Monia Ghammam 1 , El Ghali Wassim 2 , Malika El Omri 1 , Abir Meherzi 1 , Mouna Bellakhdhar 1 , Yosra Hasni El Abed 3 , Wassim Kermani 1 & Mohamed Abdelkafi 1
1Farhat Hached Hospital, ENT Department, Sousse, Tunisia; 2Department of Anaesthesia, Sousse, Tunisia; 3Department of Endocrinology, Sousse, Tunisia
Introduction: Follicular thyroid cancer is the second most common differentiated thyroid cancer and accounts for approximately 10–15% of all thyroid cancers. It tends to invade blood vessels and metastasise by haematogenous spread to distant sites, most commonly to the bones and lungs. The incidence of distant metastasis in follicular thyroid cancer has been reported as 6–20%. Metastases to the retropharyngeal lymph nodes are extremely rare. the aim of this work is to document a rare case of retropharyngeal metastasis from a follicular carcinoma of the thyroid and to describe its evolutionary characteristics.
Materials and Methods: We present the case of a patient who underwent surgery at our ENT department for a follicular carcinoma of the thyroid, with the discovery of a voluminous retropharyngeal metastasis during follow-up.
Observation: We report the case of a 60-year-old woman followed for thyroid goiter, clinically and biologically euthyroid. Ultrasound revealed a multinodular goiter without suggestive signs of malignancy. The patient underwent total thyroidectomy due to dysphagia. The final pathological examination confirmed a follicular carcinoma of the right lobe of the thyroid classified as T3NoM0. Additional radioactive iodine therapy was indicated. The course was marked by the appearance, six months later, of nodal metastases in the IIA and IIB chain with thrombosis of the right internal jugular vein. The patient underwent a right radical neck dissection. During follow-up, an increase in serum thyroglobulin levels was noted despite adequate radioiodine therapy. Clinical examination revealed no abnormalities. A cervical ultrasound returned normal results. A CT scan revealed a large right retropharyngeal mass measuring 4 cm, suggestive of retropharyngeal lymph node metastasis associated with a costal bone metastasis. The patient passed away one month later.
Conclusion: The incidence of distant metastasis after total thyroidectomy for thyroid cancer is between 7% and 23%. Although rare, retropharyngeal lymph node metastasis should be considered during the follow-up of thyroid carcinomas.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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