Endocrine Abstracts

Introduction: Cystic cervical metastases of papillary thyroid carcinoma are rare. They precise incidence remains unknown. They can be indicative of a particularly papillary thyroid cancer. However, there is no negative prognostic character compared to non-cystic lymphadenopathy of thyroid carcinoma of the same histopathological type. We aim through this series of cases to discuss diagnostic and therapeutic features of cystic metastases of papillary thyroid carcinoma.

Materials and methods: This is a retrospective study of eight patients who managed for cervical cystic metastasis related to thyroid cancinoma in our ENT department over a period of 11 years (2010-2023). The following data were studied: age, sex, patients ‘plaints, data from the clinical examination and explorations as well as the therapeutic approach.

Results: The patients‘mean age was of 45.8 years [26-84 years]. The sex ratio is 0.57 with female predominance. The circumstance of diagnosis was a laterocervical swelling in seven patients and an incidental mass on a cervical ultrasound in one case. The supraclavicular localization was found in three cases and in the jugulo-carotid chain in four cases. All of our patients underwent a cervical ultrasound which showed the presence of a cervical cystic mass in all cases. Cervical CT scan was performed in four cases. Malignancy was suggested in three cases based on the presence of intra-cystic microcalcifications. Suspicious thyroid nodules were found in four patients. A fine needle aspiration were performed in all patients. It concluded to cystic metastasis of papillary thyroid carcinoma in five cases. Total thyroidectomy with bilateral recurrent and functional lymphadenectomy was performed in all patients. The histological examination confirmed the diagnosis of papillary thyroid carcinoma in the thyroid gland with cystic metastases. Iratherapy was performed in all patients. Recurrence occurred in only one patient after an average of eight years of fellow-up.

Discussion/Conclusion: Cystic metastases of papillary thyroid carcinoma is a classical but not common. Even though, there are no differences in therapeutic procedure or prognostic compared to classical metastases, we should think about cystic metastases in cases of cervical cystic mass in adult particularly in women. High resolution cervical ultrasound and fine needle aspiration are good tools to accurate the diagnosis.

Disclosure of interest: none declared

Keywords: cystic metastasis, thyroid cancer, papillary carcinoma, surgery