Metastasis into parapharyngeal lymph node in papilary thyroid cancer
Authors:
Pavel Širůček 1,2; Martin Havel 1,2; Kamil Bukovanský 1
Authors‘ workplace:
Klinika nukleární medicíny
; FN Ostrava a
1; Lékařská fakulta Ostravské univerzity
2
Published in:
NuklMed 2014;3:74-76
Category:
Casuistry
Overview
54-year old man underwent total thyroidectomy and right block neck dissection with histological evidence of papillary carcinoma with metastatic nodal involvement. After the therapy of 3.7 GBq 131I and subsequent bilateral cervical revision with identification of positive nodal metastases he underwent additional therapy of 7.4 GBq 131I 6 months later. The posttherapeutic scintigraphy revealed persistent residual tissue of the thyroid gland and nodal metastasis located in the parapharyngeal space in front of the cervical spine at the level of C1-C2. The precise localization was allowed by hybrid SPECT/CT imaging. The spread of tumor cranially (retrogradely) requires the involvement of the retropharyngeal lymph pathways. Cervical lymph node dissection and metastatic involvement of cervical lymph nodes may change the direction of lymphatic drainage retrogradely, resulting in unusual localization of metastases in para- or retropharyngeal space.
Key words:
carcinoma of the thyroid gland, parapharyngeal lymph node metastasis, hybrid SPECT/CT imaging
Sources
1. Lombardi D, Nicolai P, Antonelli AR et al. Parapharyngeal lymph node metastasis: an unusual presentation of papillary thyroid carcinoma. Head & neck 2004;26:190-196
2. Robbins KT, Woodson GE. Thyroid carcinoma presenting as a parapharyngeal mass. Head & neck surgery 1985;7:434-436
3. Ortapamuk H, Arcan P, Alp A. Parapharyngeal Lymph Node Involvement in Papillary Thyroid Carcinoma. Clin Nucl Med 2003;28:947-948
4. Qiu ZL, Xu YH, Song HJ et al. Localization and identification of parapharyngeal metastases from differentiated thyroid carcinoma by 131I-SPECT/CT. Head Neck 2011;33:171–177
5. Otsuki N, Nishikawa T, Iwae S et al. Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck 2007;29:508–511
Labels
Nuclear medicine Radiodiagnostics RadiotherapyArticle was published in
Nuclear Medicine
2014 Issue 4
Most read in this issue
- Dynamic esophageal scintigraphy for detection of esophageal motility disorders – practical aspects
- Metastasis into parapharyngeal lymph node in papilary thyroid cancer
- New method for semiquantitative evaluation of 123I-MIBG in neuroblastoma – calculation of total retention score