A Case of Papillary Thyroid Cancer Without Aggressive Histological Features with Nodal Metastases Detected During Follow-Up in a Younger Patient

Abstract

The development of metastatic disease in cervical and mediastinal lymph nodes represents the most common location (74 %) for recurrent/persistent differentiated thyroid carcinoma (DTC). Although lymph node metastases are common in DTC, death is not, and the lack of clear data on the prognostic implications of small locoregional nodal disease has led to controversy in their management. Recently, it has been suggested that small, stable cervical lymph nodes, even when sonographically suspicious, may be followed in selected circumstances to document growth before proceeding with therapeutic intervention. Suspicious lymph nodes typically have a low potential for progression. Furthermore, surgical resection at the time of structural disease progression is generally successful, suggesting that selected patients with small-volume nodal disease can be offered a strategy of frequent monitoring with serial serum thyroglobulin measurements and neck ultrasonography.