Skip to main content
Erschienen in: World Journal of Surgery 5/2015

01.05.2015 | Original Scientific Report

Management of Retropharyngeal Node Metastases from Thyroid Carcinoma

verfasst von: Dana M. Hartl, Sophie Leboulleux, Fritz-Line Vélayoudom-Céphise, Haïtham Mirghani, Désirée Déandréis, Martin Schlumberger

Erschienen in: World Journal of Surgery | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Lymph node metastases are relatively common in thyroid carcinoma, but retropharyngeal nodes (RPN) are rare. Management may be surgical or non-surgical, according to the context of the disease.

Methods

Systematic review of cases reported in the literature and report of 5 cases.

Results

Most case series report surgical management, via a cervical or transoral approach. RPN was the specific object of 26 case series, with a total of 85 patients, with surgery performed in 22/26 studies. Our 5 cases illustrated various strategies in the multidisciplinary management, with surgery for three patients (also with 131I in one case), targeted therapy for one patient with concurrent distant metastases, and watch and wait for one elderly patient.

Conclusions

Management of RPN is not always surgical. Discussion of options in a multidisciplinary tumor board setting may optimize care.
Literatur
1.
Zurück zum Zitat Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 19(11):1167–1214CrossRefPubMed Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 19(11):1167–1214CrossRefPubMed
2.
Zurück zum Zitat Carty SE, Cooper DS, Doherty GM, Duh QY, Kloos RT, Mandel SJ et al (2009) Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 19(11):1153–1158CrossRefPubMed Carty SE, Cooper DS, Doherty GM, Duh QY, Kloos RT, Mandel SJ et al (2009) Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 19(11):1153–1158CrossRefPubMed
3.
Zurück zum Zitat Stack BC, Ferris RL, Goldenberg D, Haymart M, Shaha A, Sheth S et al (2012) American Thyroid Association Consensus Review and Statement Regarding the Anatomy, Terminology, and Rationale for Lateral Neck Dissection in Differentiated Thyroid Cancer. Thyroid. 22(5):501–508CrossRefPubMed Stack BC, Ferris RL, Goldenberg D, Haymart M, Shaha A, Sheth S et al (2012) American Thyroid Association Consensus Review and Statement Regarding the Anatomy, Terminology, and Rationale for Lateral Neck Dissection in Differentiated Thyroid Cancer. Thyroid. 22(5):501–508CrossRefPubMed
4.
Zurück zum Zitat Wang XL, Xu ZG, Wu YH, Liu SY, Yu Y (2012) Surgical management of parapharyngeal lymph node metastasis of thyroid carcinoma: a retrospective study of 25 patients. Chin Med J 125(20):3635–3639PubMed Wang XL, Xu ZG, Wu YH, Liu SY, Yu Y (2012) Surgical management of parapharyngeal lymph node metastasis of thyroid carcinoma: a retrospective study of 25 patients. Chin Med J 125(20):3635–3639PubMed
5.
Zurück zum Zitat Aygenc E, Kaymakci M, Karaca C, Ozdem C (2002) Papillary thyroid carcinoma metastasis to the parapharyngeal space. Eur Arch Otorhinolaryngol 259(6):322–324PubMed Aygenc E, Kaymakci M, Karaca C, Ozdem C (2002) Papillary thyroid carcinoma metastasis to the parapharyngeal space. Eur Arch Otorhinolaryngol 259(6):322–324PubMed
6.
Zurück zum Zitat Kainuma K, Kitoh R, Yoshimura H, Usami S (2011) The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature. Acta Otolaryngol 131(12):1341–1348CrossRefPubMed Kainuma K, Kitoh R, Yoshimura H, Usami S (2011) The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature. Acta Otolaryngol 131(12):1341–1348CrossRefPubMed
7.
Zurück zum Zitat Robbins KT, Woodson GE (1985) Thyroid carcinoma presenting as a parapharyngeal mass. Head Neck Surg 7(5):434–436CrossRefPubMed Robbins KT, Woodson GE (1985) Thyroid carcinoma presenting as a parapharyngeal mass. Head Neck Surg 7(5):434–436CrossRefPubMed
8.
Zurück zum Zitat Ducci M, Bozza F, Pezzuto RW, Palma L (2001) Papillary thyroid carcinoma metastatic to the parapharyngeal space. J Exp Clin Cancer Res 20(3):439–441PubMed Ducci M, Bozza F, Pezzuto RW, Palma L (2001) Papillary thyroid carcinoma metastatic to the parapharyngeal space. J Exp Clin Cancer Res 20(3):439–441PubMed
9.
Zurück zum Zitat McCormack KR, Sheline GE (1970) Retropharyngeal spread of carcinoma of the thyroid. Cancer 26(6):1366–1369CrossRefPubMed McCormack KR, Sheline GE (1970) Retropharyngeal spread of carcinoma of the thyroid. Cancer 26(6):1366–1369CrossRefPubMed
10.
Zurück zum Zitat Ferrario F, Roselli R, Macchi A (1995) Occult thyroid carcinoma presenting as a parapharyngeal mass. J Laryngol Otol 109(12):1204–1206CrossRefPubMed Ferrario F, Roselli R, Macchi A (1995) Occult thyroid carcinoma presenting as a parapharyngeal mass. J Laryngol Otol 109(12):1204–1206CrossRefPubMed
11.
Zurück zum Zitat Le TD, Cohen JI (2007) Transoral approach to removal of the retropharyngeal lymph nodes in well-differentiated thyroid cancer. Laryngoscope. 117(7):1155–1158CrossRefPubMed Le TD, Cohen JI (2007) Transoral approach to removal of the retropharyngeal lymph nodes in well-differentiated thyroid cancer. Laryngoscope. 117(7):1155–1158CrossRefPubMed
12.
Zurück zum Zitat Leger AF, Baillet G, Dagousset F, Vincenot MI, Izembart M, Clerc J et al (2000) Upper retropharyngeal node involvement in differentiated thyroid carcinoma demonstrated by 131I scintigraphy. Br J Radiol. 73(876):1260–1264CrossRefPubMed Leger AF, Baillet G, Dagousset F, Vincenot MI, Izembart M, Clerc J et al (2000) Upper retropharyngeal node involvement in differentiated thyroid carcinoma demonstrated by 131I scintigraphy. Br J Radiol. 73(876):1260–1264CrossRefPubMed
13.
Zurück zum Zitat Otsuki N, Nishikawa T, Iwae S, Saito M, Mohri M, Nibu K (2007) Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck 29(5):508–511CrossRefPubMed Otsuki N, Nishikawa T, Iwae S, Saito M, Mohri M, Nibu K (2007) Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck 29(5):508–511CrossRefPubMed
14.
Zurück zum Zitat Andrews GA, Kwon M, Clayman G, Edeiken B, Kupferman ME (2011) Technical refinement of ultrasound-guided transoral resection of parapharyngeal/retropharyngeal thyroid carcinoma metastases. Head Neck 33(2):166–170CrossRefPubMed Andrews GA, Kwon M, Clayman G, Edeiken B, Kupferman ME (2011) Technical refinement of ultrasound-guided transoral resection of parapharyngeal/retropharyngeal thyroid carcinoma metastases. Head Neck 33(2):166–170CrossRefPubMed
15.
Zurück zum Zitat Shellenberger T, Fornage B, Ginsberg L, Clayman GL (2007) Transoral resection of thyroid cancer metastasis to lateral retropharyngeal nodes. Head Neck 29(3):258–266CrossRefPubMed Shellenberger T, Fornage B, Ginsberg L, Clayman GL (2007) Transoral resection of thyroid cancer metastasis to lateral retropharyngeal nodes. Head Neck 29(3):258–266CrossRefPubMed
16.
Zurück zum Zitat Ma QD, Grimm K, Paz BI, Maghami E (2009) Transoral surgical approach for retropharyngeal node involvement in I-131-negative 18-fluoro-2-deoxyglucose positron emission tomography-positive recurrent thyroid cancer. Skull Base 19(6):431–436CrossRefPubMedCentralPubMed Ma QD, Grimm K, Paz BI, Maghami E (2009) Transoral surgical approach for retropharyngeal node involvement in I-131-negative 18-fluoro-2-deoxyglucose positron emission tomography-positive recurrent thyroid cancer. Skull Base 19(6):431–436CrossRefPubMedCentralPubMed
17.
Zurück zum Zitat Ozlugedik S, Ibrahim Acar H, Apaydin N, Firat Esmer A, Tekdemir I, Elhan A et al (2005) Retropharyngeal space and lymph nodes: an anatomical guide for surgical dissection. Acta Otolaryngol 125(10):1111–1115CrossRefPubMed Ozlugedik S, Ibrahim Acar H, Apaydin N, Firat Esmer A, Tekdemir I, Elhan A et al (2005) Retropharyngeal space and lymph nodes: an anatomical guide for surgical dissection. Acta Otolaryngol 125(10):1111–1115CrossRefPubMed
18.
Zurück zum Zitat Coskun HH, Ferlito A, Medina JE, Robbins KT, Rodrigo JP, Strojan P et al (2011) Retropharyngeal lymph node metastases in head and neck malignancies. Head Neck 33(10):1520–1529CrossRefPubMed Coskun HH, Ferlito A, Medina JE, Robbins KT, Rodrigo JP, Strojan P et al (2011) Retropharyngeal lymph node metastases in head and neck malignancies. Head Neck 33(10):1520–1529CrossRefPubMed
19.
Zurück zum Zitat Rouvière H (1932) Anatomie des Lymphatiques de l’Homme. Masson, Paris Rouvière H (1932) Anatomie des Lymphatiques de l’Homme. Masson, Paris
20.
Zurück zum Zitat Erdem T, Miman MC, Oncel S, Mizrak B (2003) Metastatic spread of occult papillary carcinoma of the thyroid to the parapharyngeal space: a case report. Kulak Burun Bogaz Ihtis Derg. 10(6):244–247PubMed Erdem T, Miman MC, Oncel S, Mizrak B (2003) Metastatic spread of occult papillary carcinoma of the thyroid to the parapharyngeal space: a case report. Kulak Burun Bogaz Ihtis Derg. 10(6):244–247PubMed
21.
Zurück zum Zitat Thomas G, Pandey M, Jayasree K, Pradeep VM, Abraham EK, Iype EM et al (2002) Parapharyngeal metastasis from papillary microcarcinoma of thyroid: report of a case diagnosed by peroral fine needle aspiration. Br J Oral Maxillofac Surg 40(3):229–231CrossRefPubMed Thomas G, Pandey M, Jayasree K, Pradeep VM, Abraham EK, Iype EM et al (2002) Parapharyngeal metastasis from papillary microcarcinoma of thyroid: report of a case diagnosed by peroral fine needle aspiration. Br J Oral Maxillofac Surg 40(3):229–231CrossRefPubMed
22.
Zurück zum Zitat Kaplan SL, Mandel SJ, Muller R, Baloch ZW, Thaler ER, Loevner LA (2009) The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol 30(3):608–612CrossRefPubMed Kaplan SL, Mandel SJ, Muller R, Baloch ZW, Thaler ER, Loevner LA (2009) The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol 30(3):608–612CrossRefPubMed
23.
Zurück zum Zitat Tomoda C, Matsuzuka F, Miyauchi A (2005) Parapharyngeal metastasis from papillary thyroid carcinoma: a case diagnosed by thyroglobulin measurement in peroral fine-needle aspiration of a cystic metastatic lymph node. J Laryngol Otol 119(2):155–157CrossRefPubMed Tomoda C, Matsuzuka F, Miyauchi A (2005) Parapharyngeal metastasis from papillary thyroid carcinoma: a case diagnosed by thyroglobulin measurement in peroral fine-needle aspiration of a cystic metastatic lymph node. J Laryngol Otol 119(2):155–157CrossRefPubMed
24.
Zurück zum Zitat Pearlman SJ, Lawson W, Biller HF (1988) Occult medullary carcinoma of the thyroid presenting as neck and parapharyngeal metastases. Otolaryngol Head Neck Surg 99(5):509–512PubMed Pearlman SJ, Lawson W, Biller HF (1988) Occult medullary carcinoma of the thyroid presenting as neck and parapharyngeal metastases. Otolaryngol Head Neck Surg 99(5):509–512PubMed
25.
Zurück zum Zitat Machens A, Dralle H (2010) Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab 95(6):2655–2663CrossRefPubMed Machens A, Dralle H (2010) Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab 95(6):2655–2663CrossRefPubMed
26.
Zurück zum Zitat Machens A, Schneyer U, Holzhausen HJ, Dralle H (2005) Prospects of remission in medullary thyroid carcinoma according to basal calcitonin level. J Clin Endocrinol Metab 90(4):2029–2034CrossRefPubMed Machens A, Schneyer U, Holzhausen HJ, Dralle H (2005) Prospects of remission in medullary thyroid carcinoma according to basal calcitonin level. J Clin Endocrinol Metab 90(4):2029–2034CrossRefPubMed
27.
Zurück zum Zitat Martin HE (1957) Surgery of head and neck tumors. Hoeber-Harper, New York Martin HE (1957) Surgery of head and neck tumors. Hoeber-Harper, New York
28.
Zurück zum Zitat Laccourreye L, Breheret R, Rohmer V, Dubin J, Bizon A (2008) Transoral resection of thyroid cancer metastasis to retropharyngeal lymph node. Ann Otolaryngol Chir Cervicofac 125(6):309–312CrossRefPubMed Laccourreye L, Breheret R, Rohmer V, Dubin J, Bizon A (2008) Transoral resection of thyroid cancer metastasis to retropharyngeal lymph node. Ann Otolaryngol Chir Cervicofac 125(6):309–312CrossRefPubMed
29.
Zurück zum Zitat Sirotnak JJ, Loree TR, Penetrante R (1997) Papillary carcinoma of the thyroid metastatic to the parapharyngeal space. Ear Nose Throat J 76(5):342–344PubMed Sirotnak JJ, Loree TR, Penetrante R (1997) Papillary carcinoma of the thyroid metastatic to the parapharyngeal space. Ear Nose Throat J 76(5):342–344PubMed
30.
Zurück zum Zitat Deandreis D, Al Ghuzlan A, Leboulleux S, Lacroix L, Garsi JP, Talbot M et al (2011) Do histological, immunohistochemical, and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr Relat Cancer 18(1):159–169CrossRefPubMed Deandreis D, Al Ghuzlan A, Leboulleux S, Lacroix L, Garsi JP, Talbot M et al (2011) Do histological, immunohistochemical, and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr Relat Cancer 18(1):159–169CrossRefPubMed
31.
Zurück zum Zitat Kim JH, Kim MS, Yoo SY, Lim SM, Lee GH, Yi KH (2010) Stereotactic body radiotherapy for refractory cervical lymph node recurrence of nonanaplastic thyroid cancer. Otolaryngol Head Neck Surg 142(3):338–343CrossRefPubMed Kim JH, Kim MS, Yoo SY, Lim SM, Lee GH, Yi KH (2010) Stereotactic body radiotherapy for refractory cervical lymph node recurrence of nonanaplastic thyroid cancer. Otolaryngol Head Neck Surg 142(3):338–343CrossRefPubMed
32.
Zurück zum Zitat Desuter G, Lonneux M, Plouin-Gaudon I, Jamar F, Coche E, Weynand B, et al (2004) Parapharyngeal metastases from thyroid cancer. Eur J Surg Oncol 30(1):80–84CrossRefPubMed Desuter G, Lonneux M, Plouin-Gaudon I, Jamar F, Coche E, Weynand B, et al (2004) Parapharyngeal metastases from thyroid cancer. Eur J Surg Oncol 30(1):80–84CrossRefPubMed
33.
Zurück zum Zitat Lombardi D, Nicolai P, Antonelli AR, Maroldi R, Farina D, Shaha AR (2004) Parapharyngeal lymph node metastasis: an unusual presentation of papillary thyroid carcinoma. Head Neck 26(2):190–196CrossRefPubMed Lombardi D, Nicolai P, Antonelli AR, Maroldi R, Farina D, Shaha AR (2004) Parapharyngeal lymph node metastasis: an unusual presentation of papillary thyroid carcinoma. Head Neck 26(2):190–196CrossRefPubMed
34.
Zurück zum Zitat Imai T, Tanaka Y, Matsuura N, Takahashi M, Torii S, Funahashi H (1999) Successful surgical treatment of a solitary parapharyngeal metastasis from thyroid cancer, using the mandibular swing-transcervical approach: report of a case. Surg Today 29(4):378–381CrossRefPubMed Imai T, Tanaka Y, Matsuura N, Takahashi M, Torii S, Funahashi H (1999) Successful surgical treatment of a solitary parapharyngeal metastasis from thyroid cancer, using the mandibular swing-transcervical approach: report of a case. Surg Today 29(4):378–381CrossRefPubMed
35.
Zurück zum Zitat Saydam L, Kalcioglu T, Demirkiran A, Gurer M (1999) Occult papillary thyroid carcinoma presenting as a parapharyngeal metastasis. Am J Otolaryngol 20(3):166–168CrossRefPubMed Saydam L, Kalcioglu T, Demirkiran A, Gurer M (1999) Occult papillary thyroid carcinoma presenting as a parapharyngeal metastasis. Am J Otolaryngol 20(3):166–168CrossRefPubMed
36.
Zurück zum Zitat Carrau RL, Myers EN, Johnson JT (1990) Management of tumors arising in the parapharyngeal space. Laryngoscope 100(6):583–589CrossRefPubMed Carrau RL, Myers EN, Johnson JT (1990) Management of tumors arising in the parapharyngeal space. Laryngoscope 100(6):583–589CrossRefPubMed
Metadaten
Titel
Management of Retropharyngeal Node Metastases from Thyroid Carcinoma
verfasst von
Dana M. Hartl
Sophie Leboulleux
Fritz-Line Vélayoudom-Céphise
Haïtham Mirghani
Désirée Déandréis
Martin Schlumberger
Publikationsdatum
01.05.2015
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 5/2015
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-2947-2

Weitere Artikel der Ausgabe 5/2015

World Journal of Surgery 5/2015 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.