European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 6, pp 1809–1814 | Cite as

Functional and oncological outcomes after retropharyngeal node dissection for papillary thyroid carcinoma

  • Naoki OtsukiEmail author
  • Naruhiko Morita
  • Tatsuya Furukawa
  • Masanori Teshima
  • Hitomi Shinomiya
  • Hirotaka Shinomiya
  • Ken-ichi Nibu
Head & Neck



Papillary thyroid carcinoma frequently metastasizes to central and lateral neck lymph nodes, but metastasis to retropharyngeal lymph nodes (RPLN) is rare.

Patients and methods

We retrospectively reviewed 16 patients with RPLN metastasis of PTC who underwent therapeutic dissection of RPLN metastases.


Among 16 patients, 7 patients underwent RPLN dissection with initial surgery and remaining 9 patients as salvage surgery. RPLN metastasis arose unilaterally in 15 patients and bilaterally in 1 patient. Eleven patients showed temporal dysphagia and four patients showed temporal vocal cord paralysis, but both symptoms eventually recovered in all cases. Two patients with salvage RPLN dissection died of distant metastasis and six patients survived with distant metastasis and/or persistent loco-regional disease. Other eight patients have been alive without disease.


Although transcervical approach for RPLN metastases of PTC provided acceptable functional and oncological outcomes, half of the patients with RPLN metastasis have had distant metastasis and/or persistent locoregional disease. Indications of surgery for patients with RPLN metastasis need to be performed carefully in consideration of patients' prognosis and quality of life.


Retropharyngeal node Metastasis Thyroid carcinoma Functional and oncological outcome Surgery 


Compliance with ethical standards

Conflict of interest

All authors have no conflict of interests to be disclosed on this work.

Ethical approval

The study was conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and it later amendments. Ethical approval was obtained from the Ethics Committee of the Kobe University Hospital (#190195) prior to enrolment.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    McCormack KR, Sheline GE (1970) Retropharyngeal spread of carcinoma of the thyroid. Cancer 26(6):1366–1369CrossRefGoogle Scholar
  2. 2.
    Robbins KT, Woodson GE (1985) Thyroid carcinoma presenting as a parapharyngeal mass. Head Neck Surg 7(5):434–436CrossRefGoogle Scholar
  3. 3.
    Leger AF, Baillet G, Dagousset F, Vincenot MI, Izembart M, Clerc J, Barritault L (2000) Upper retropharyngeal node involvement in differentiated thyroid carcinoma demonstrated by 131I scintigraphy. Br J Radiol 73(876):1260–1264CrossRefGoogle Scholar
  4. 4.
    Ducci M, Bozza F, Pezzuto RW, Palma L (2001) Papillary thyroid carcinoma metastatic to the parapharyngeal space. J Exp Clin Cancer Res 20(3):439–441Google Scholar
  5. 5.
    Desuter G, Lonneux M, Plouin-Gaudon I, Jamar F, Coche E, Weynand B, Rahier J, Grégoire V, Andry G, Hamoir M (2004) Parapharyngeal metastases from thyroid cancer. Eur J Surg Oncol 30(1):80–84CrossRefGoogle Scholar
  6. 6.
    Aygenc E, Kaymakci M, Karaca C, Ozdem C (2002) Papillary thyroid carcinoma metastasis to the parapharyngeal space. Eur Arch Otorhinolaryngol 259(6):322–324Google Scholar
  7. 7.
    Otsuki N, Nishikawa T, Iwae S, Saito M, Mohri M, Nibu K (2007) Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck 29(5):508–511CrossRefGoogle Scholar
  8. 8.
    Togashi T, Sugitani I, Toda K, Kawabata K, Takahashi S (2014) Surgical management of retropharyngeal nodes metastases from papillary thyroid carcinoma. World J Surg 38(11):2831–2837CrossRefGoogle Scholar
  9. 9.
    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):3635–3639Google Scholar
  10. 10.
    Moritani S (2016) Parapharyngeal metastasis of papillary thyroid carcinoma. World J Surg 40(2):350–355CrossRefGoogle Scholar
  11. 11.
    Edge SB, Greene F, Byrd DR, Brookland RK, Washington MK (2016) AJCC cancer staging manual, 8th edn. Springer, New YorkGoogle Scholar
  12. 12.
    Perrier ND, Brierley JD, Tuttle RM (2018) Differentiated and anaplastic thyroid carcinoma: major changes in the American Joint Committee on Cancer eight edition cancer staging manual. CA Cancer J Clin 68:55–63CrossRefGoogle Scholar
  13. 13.
    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):190–196CrossRefGoogle Scholar
  14. 14.
    Ferrario F, Roselli R, Macchi A (1995) Occult thyroid carcinoma presenting as a parapharyngeal mass. J Laryngol Otol 109(12):1204–1206CrossRefGoogle Scholar
  15. 15.
    Rouviere H (1967) Anatomic Humaine, Descriptive et Topograhique, 10th edn. Masson et Cie, Paris, p 506Google Scholar
  16. 16.
    Shellenberger T, Fornage B, Ginsberg L, Clayman GL (2007) Transoral resection of thyroid cancer metastasis to lateral retropharyngeal nodes. Head Neck 29(3):258–266CrossRefGoogle Scholar
  17. 17.
    Fujiwara K, Fukuhara T, Koyama S, Donishi R, Kataoka H, Kitano H, Takeuchi H (2017) Ultrasound-guided transoral videolaryngoscopic surgery for retropharyngeal lymph node metastasis of papillary thyroid cancer. Case Rep Oncol 10(2):649–655CrossRefGoogle Scholar
  18. 18.
    Moore MW, Jantharapattana K, Williams MD, Grant DG, Selber JC, Holsinger FC (2011) Retropharyngeal lymphadenectomy with transoral robotic surgery for papillary thyroid cancer. J Robot Surg 5(3):221CrossRefGoogle Scholar
  19. 19.
    Goepfert RP, Liu C, Ryan WR (2015) Trans-oral robotic surgery and surgeon-performed trans-oral ultrasound for intraoperative location and excision of an isolated retropharyngeal lymph node metastasis of papillary thyroid carcinoma. Am J Otolaryngol 36(5):710–714CrossRefGoogle Scholar
  20. 20.
    Hartl DM, Leboulleux S, Vélayoudom-Céphise FL, Mirghani H, Déandréis D, Schlumberger M (2015) Management of retropharyngeal node metastases from thyroid carcinoma. World J Surg 39(5):1274–1281CrossRefGoogle Scholar
  21. 21.
    Kiess AP, Agrawal N, Brierley JD, Duvvuri U, Ferris RL, Genden E, Wong RJ, Tuttle RM, Lee NY, Randolph GW (2016) External-beam radiotherapy for differentiated thyroid cancer locoregional control: a statement of the American Head and Neck Society. Head Neck 38(4):493–498CrossRefGoogle Scholar
  22. 22.
    Bernstein MB, Chang EL, Amini B, Pan H, Cabanillas M, Wang XA, Allen PK, Rhines LD, Tatsui C, Li J, Brown PD, Ghia AJ (2016) Spine stereotactic radiosurgery for patients with metastatic thyroid cancer: secondary analysis of phase I/II trials. Thyroid 26(9):1269–1275CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan

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