Skip to main content
Log in

Parapharyngeal Metastasis of Papillary Thyroid Carcinoma

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Nodal involvement of papillary thyroid carcinoma (PTC) commonly occurs in the paratracheal region and the internal jugular chain. Lymph node metastasis in the parapharyngeal space (PPS) is rare. In this report, we describe our experience and surgical outcomes of patients with PPS metastasis of PTC.

Methods

Clinical data of patients with PTC who underwent surgery at our institution between January 2006 and December 2013 were retrospectively reviewed, and 22 patients with PPS metastasis were enrolled.

Results

There were 2 primary and 20 secondary cases of PPS metastasis. Involvement of the jugular nodes was noted before or at the time of PPS metastasis detection in all cases. A transcervical surgical approach with partial resection of the mandibular angle was performed in 21 patients, while 1 patient underwent extirpation of the PPS metastasis via a transoral approach. Although curative resection was performed in 21 patients, the PPS metastasis was not removable in 1 patient owing to an invaded internal carotid artery at the skull base. Twelve and 6 patients had locoregional and distant recurrence, respectively. Of the 12 patients with locoregional recurrence, isolated locoregional recurrence in the PPS occurred in 1. Eight patients died of distant or locoregional recurrence, with a median survival time of 91.7 months.

Conclusions

For patients who experience recurrence after thyroid surgery, the possibility of PPS metastasis should be considered. In this series, all patients with PPS metastasis also had previous unilateral or bilateral cervical metastasis. Despite curative attempt, most patients experienced local or distant recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Khafif A, Segev Y, Kaplan DM et al (2005) Surgical management of parapharyngeal space tumors: a 10-year review. Otolaryngol Head Neck Surg 132:401–406

    Article  PubMed  Google Scholar 

  2. Batsakis JG, Sneige N (1989) Parapharyngeal and retropharyngeal space diseases. Ann Otol Rhinol Laryngol 98:320–321

    Article  PubMed  CAS  Google Scholar 

  3. Pensak ML, Gluckman JL, Shumrick KA (1994) Parapharyngeal space tumors: an algorithm for evaluation and management. Laryngoscope 104:1170–1173

    PubMed  CAS  Google Scholar 

  4. Carrau RL, Johnson JT, Myers EN (1997) Management of tumors of the parapharyngeal space. Oncology 11:633–640 discussion 640, 642

    PubMed  CAS  Google Scholar 

  5. Cohen SM, Burkey BB, Netterville JL (2005) Surgical management of parapharyngeal space masses. Head Neck 27:669–675

    Article  PubMed  Google Scholar 

  6. Shahab R, Heliwell T, Jones AS (2005) How we do it: a series of 114 primary pharyngeal space neoplasms. Clin Otolaryngol 30:364–367

    Article  PubMed  CAS  Google Scholar 

  7. Olsen KD (1994) Tumors and surgery of the parapharyngeal space. Laryngoscope 104:1–28

    Article  PubMed  CAS  Google Scholar 

  8. Podnos YD, Smith D, Wagman LD et al (2005) The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer. Am Surg 71:731–734

    PubMed  Google Scholar 

  9. Zaydfudim V, Feurer ID, Griffin MR et al (2008) The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery 144:1070–1077 discussion 1077–1078

    Article  PubMed  Google Scholar 

  10. Smith VA, Sessions RB, Lentsch EJ (2012) Cervical lymph node metastasis and papillary thyroid carcinoma: does the compartment involved affect survival? Experience from the SEER database. J Surg Oncol 106:357–362

    Article  PubMed  Google Scholar 

  11. Moritani S (2014) Impact of invasive extranodal extension on the prognosis of patients with papillary thyroid carcinoma. Thyroid 24:1779–1783

    Article  PubMed  Google Scholar 

  12. Kainuma K, Kitoh R, Yoshimura H et al (2011) The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature. Acta Otolaryngol 131:1341–1348

    Article  PubMed  Google Scholar 

  13. Desuter G, Lonneux M, Plouin-Gaudon I et al (2004) Parapharyngeal metastases from thyroid cancer. Eur J Surg Oncol 30:80–84

    Article  PubMed  CAS  Google Scholar 

  14. Rouviere H (1967) Anatomie Humaine, Descriptive et Topograhique, 10th edn. Masson et Cie, Paris, p 506

    Google Scholar 

  15. Otsuki N, Nishikawa T, Iwae S et al (2007) Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck 29:508–511

    Article  PubMed  Google Scholar 

  16. McCormack KR, Sheline GE (1970) Retropharyngeal spread of carcinoma of the thyroid. Cancer 26:1366–1369

    Article  PubMed  CAS  Google Scholar 

  17. Bozza F, Vigili MG, Rusctio P et al (2009) Surgical management of parapharyngeal space tumours: results of 10-year follow-up. Acta Otorhinolaryngol Ital 29:10–15

    PubMed  CAS  PubMed Central  Google Scholar 

  18. Kaplan SL, Mandel SJ, Muller R et al (2009) The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol 30:608–612

    Article  PubMed  CAS  Google Scholar 

  19. Eisele DW, Richmon JD (2013) Contemporary evaluation and management of parapharyngeal space neoplasms. J Laryngol Otol 127:550–555

    Article  PubMed  CAS  Google Scholar 

  20. Byeon HK, Duvvuri U, Kim WS et al (2013) Transoral robotic retropharyngeal lymph node dissection with or without lateral oropharyngectomy. J Craniofac Surg 24:1156–1161

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sueyoshi Moritani.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moritani, S. Parapharyngeal Metastasis of Papillary Thyroid Carcinoma. World J Surg 40, 350–355 (2016). https://doi.org/10.1007/s00268-015-3321-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-015-3321-0

Keywords

Navigation