Shu-Wei Chen1-3 and Wei-Wei Liu1-3*
1Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, China
2Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, China
3Department of Head and Neck Surgery, Collaborative Innovation Center of Cancer Medicine, China
Background: Papillary Thyroid Carcinomas (PTCs) rarely metastasize to the Suprahyoid Retropharyngeal Lymph Nodes (SRPLNs). Studies on SRPLN metastasis from PTCs and description of dissection of SRPLNs via the transcervical approach are rare in the literature. Methods: We retrospectively reviewed 6 patients (three men, three women) diagnosed as PTCs with SRPLN metastasis who underwent dissection of SRPLNs between 2001 and 2017.Median age at dissection was 38 years (range 12-58). A transcervical approach was applied for exposure and dissection of SRPLNs in all patients. Dissection of SRPLNs was performed simultaneously with the initial surgery for PTC in five patients, while the remaining one patient underwent dissection as secondary surgery. Results: All patients were successfully treated by transcervical resection of the metastatic SRPLNs from PTCs. No patient needed mandibulotomy or presented severe complications. Median duration of follow-up after dissection of SRPLNs was 83 months (range, 15-213). No recurrence of SRPLN metastasis was identified during follow-up, and none of the patients died of the disease. Conclusion: SRPLN metastasis from PTCs presents most likely in patients with advanced lesions. Surgery might be the best treatment for cure. Surgical removal of metastatic SRPLN through transcervical approach was safe and effective. The surgical route through three main anatomical barriers to the retropharyngeal space and the landmarks to identify SRPLN should be well known for the surgeons.
Chen S-W, Liu W-W. Transcervical Dissection of Metastatic Suprahyoid Retropharyngeal Lymph Nodes from Papillary Thyroid Carcinoma through Three Anatomical Barriers. Clin Surg. 2019; 4: 2629..