We retrospectively reviewed thyroid occult carcinomas that were first detected as cervical lymph node metastasis at our hospital. Between 1980 and 1999, and found that of 481 patients with thyroid carcinomas who underwent treatment at the Kurume University Hospital 11 cases (2.3%) were diagnosed as thyroid occult carcinoma based on cervical lymph node biopsy. Histologically 10 of these patients were diagnosed with papillary carcinoma and 1 patient with follicular carcinoma. Preoperative ultrasonography was performed in 10 patients with papillary carcinoma, and in 2 cases, small high echoic spots were detected but there was no evidence of tumors. In the other 8 cases, there were no abnormal findings in the thyroid.
Unilateral neck dissection with thyroid lobectomy was performed in seven cases and unilateral or bilateral neck dissection with total thyroidectomy was performed in four cases. In all the cases, postoperative pathological examination confirmed at least one microcarcinoma 1.0cm or less in diameter in the thyroid. In 5 cases, multif ocal tumors were proven histologically.
Nine patients were alive at between 1 year and 13 years postoperatively and two patients died from other diseases without any evidence of recurrence of the thyroid carcinoma.
