Three cases of metastases from papillary thyroid carcinoma detected in specimens obtained by neck dissection for oral cancer

Abstract

Incidental detection of cervical lymph node metastasis from thyroid carcinoma during neck dissection for oral cancer is uncommon clinically. There is no consensus regarding the treatment of primary thyroid lesions associated with metastasis.
Cervical lymph node metastasis from papillary thyroid carcinoma (PTC) was detected incidentally in 3 of 325 patients who underwent radical neck dissection for metastasis of oral squamous cell carcinoma (SCC) between 1978 and 2002. The patients were one man and two women 44 to 56 years of age. All three patients had SCC of the tongue. Physical examination and radiologic evaluation showed no intrathyriodal lesions. PTC had metastasized to the cervical lymph nodes at levels II to IV. The patients did not receive additional treatment for their thyroid lesions and were followed-up by computed tomographic and echographic examinations. PTC did not show any growth or metastasis during the follow-up period (2 years 11 months - 8 years 7 months), although one of the patients died of recurrence of SCC 2 years later.
PTC is usually indolent and associated with low mortality. We suggest that incidental PTC should be followed by imaging studies when the thyroid gland shows no clinical or radiologic evidence of lesions.