ECE2024 Eposter Presentations Thyroid (198 abstracts)
1ENT Department Farhat Hached Hospital, Sousse, Tunisia; 2Endocrinology Department Farhat Hached Hospital, Sousse, Tunisia
Introduction: Metastasis in adenopathy accompanying thyroid microcarcinoma (TMC) is a rare clinical situation. We propose to study the risk factors for their occurrence, their clinical characteristics and their therapeutic methods.
Material and methods: A retrospective study of 14 cases of TMC associated with metastatic cervical adenopathy collected in our ENT department, between 1990 and 2023.
Results: The cases studied represented 25% of all TMCs operated on during the same period. The mean age was 47.2 years, with a female predominance. The mean size of the adenopathy was 3 cm. The thyroid gland was clinically anodular in 10 cases. 13 patients had a cervical ultrasound scan showing calcifications within the adenopathy in 4 cases, considered to be a branchial cyst in one case. The thyroid was anodular in 7 cases. A cervical Computed tomography scan was performed in the case of an 8 cm lesion that had fistulated to the skin. It showed the appearance of an 84 mm multiloculated left latero-cervical mass with hypodense necrotic content and heterogeneous calcified peripheral enhancement infiltrating the lateral border of the sternocleidomastoid muscle, and an 8 mm left lobar thyroid nodule. Total thyroidectomy was performed in all our patients, together with a bilateral mediastino-recurrent dissection with unilateral lateral lymph node dissection in 12 cases and bilateral dissection in one case. Adjuvant treatment was performed in 13 patients with Iodine-131.
Conclusion: The presence of adenopathy during TMC is rare. This diagnosis should be considered in young patients. It reflects aggressivity of the tumor.