Skip to main content
SpringerLink
Log in

Sentinel lymph node biopsy in thyroid tumors: a pilot study

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The purpose of this study was to assess the feasibility of sentinel lymph node (SLN) biopsy in thyroid neoplasms. Ten patients with uninodular thyroid disease and no evidence of lymph node metastases were examined. Lymph node mapping was performed by preoperative lymphoscintigraphy and intraoperative use of a hand-held gammaprobe. Following thyroidectomy, the SLN(s) were selectively excised and worked-up histologically for occult metastases. Overall detection of SLNs was possible in 50% of the cases with lymphoscintigraphy and in 100% with the gammaprobe. All SLNs in the lateral compartment and upper mediastinum were accurately detected with lymphoscintigraphy. One patient with a papillary carcinoma showed a metastasis in the SLN. One patient experienced temporary lesion of the recurrent laryngeal nerve. In conclusion, sentinel lymph node biopsy is technically feasible. The combination of lymphoscintigraphy and gammaprobe accurately reveals SLNs in the central and lateral compartment and in the mediastinum. Search for SLNs in the lower central compartment enhances the risk of injuring the recurrent laryngeal nerve. The clinical relevance of SLN biopsy in papillary thyroid cancer is unclear, and the subgroup of patients benefiting from it has still to be defined.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Alex JC, Sasaki CT, Krag DN, Wenig B, Pyle PB (2000) Sentinel lymph node radiolocalization in head and neck squamous cell carcinoma. Laryngoscope 110: 198–203

    CAS  PubMed  Google Scholar 

  2. Arch-Ferrer J, Velazquez D, Fajardo R, Gamboa-Dominguez A, Herrera MF (2001) Accuracy of sentinel lymph node in papillary thyroid carcinoma. Surgery 130: 907–913

    Article  CAS  PubMed  Google Scholar 

  3. Attie JN, Khafif RA, Steckler RM (1971) Elective neck dissection in papillary carcinoma of the thyroid. Am J Surg 22: 464–471

    Google Scholar 

  4. Ballantyne AJ (1991) Neck dissection for thyroid cancer. Semin Surg Oncol 7: 100–106

    CAS  PubMed  Google Scholar 

  5. Catarci M, Zaraca F, Angeloni R, Mancini B, De Filippo MG, Massa R, Carboni M, Pasquini G (2001) Preoperative lymphoscintigraphy and sentinel lymph node biopsy in papillary thyroid cancer. A pilot study. J Surg Oncol 77: 21–24

    Article  CAS  PubMed  Google Scholar 

  6. Coburn MC, Wanebo HJ (1992) Prognostic factors and management considerations in patients with cervical metastases of thyroid cancer. Am J Surg 164: 671–676

    CAS  PubMed  Google Scholar 

  7. Dixon E, McKinnon GJ, Pasieka JL (2000) Feasibility of sentinel lymph node biopsy and lymphatic mapping in nodular thyroid neoplasms. World J Surg 24: 1396–1401

    CAS  PubMed  Google Scholar 

  8. Fukui Y, Yamakawa T, Taniki T, Numoto S, Miki H, Monden Y (2001) Sentinel lymph node biopsy in patients with papillary carcinoma. Cancer 92: 2868–2874

    Article  CAS  PubMed  Google Scholar 

  9. Hermanek P, Hutter RVP, Sobin LH, Wittekind C (1999) Classification of isolated tumor cells and micrometastasis. Cancer 86: 2668–2673

    Article  CAS  PubMed  Google Scholar 

  10. Hughes CJ, Shaha AR, Shah JP, Loree TR (1996) Impact of lymph node metastasis in differentiated carcinoma of the thyroid: A matched pair analysis. Head Neck 18: 127–132

    Article  CAS  PubMed  Google Scholar 

  11. Kelemen PR, Van Herle AJ, Giuliano AE (1998) Sentinel lymphadenectomy in thyroid malignant neoplasms. Arch Surg 133: 288–292

    CAS  PubMed  Google Scholar 

  12. Krag DN (1993) Surgical resection and radiolocalization of the SLN in breast cancer using a gamma probe. Surg Oncol 2: 335–340

    CAS  PubMed  Google Scholar 

  13. Lin JD, Liou MJ, Chao TC, Weng HF, Ho YS (1999) Prognostic variables of papillary and follicular thyroid carcinoma patients with lymph node metastases. Endocr Relat Cancer 6: 109–115

    CAS  PubMed  Google Scholar 

  14. Mazzaferri EL, Jhiang SM (1994) Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 97: 418–428

    CAS  PubMed  Google Scholar 

  15. McConahey WM, Hay ID, Woolner LB, van Heerden JA, Taylor WF (1986) Papillary thyroid cancer treated at the Mayo Clinic 1946 through 1970. Mayo Clin Proc 61: 978–996

    CAS  PubMed  Google Scholar 

  16. McHenry CR, Rosen IB, Walfish PG (1991) Prospective management of nodal metastases in differentiated thyroid cancer. Am J Surg 162: 353–356

    CAS  PubMed  Google Scholar 

  17. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, Foshag LJ, Cochran AJ (1992) Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 127: 392–399

    PubMed  Google Scholar 

  18. Noguchi M, Kinami S, Kinoshita K, Kitagawa H, Thomas M, Miyazaki I, Michigishi T, Mizukami Y (1993) Risk of bilateral cervical lymph node metastases in papillary thyroid cancer. J Surg Oncol 52: 155–159

    CAS  PubMed  Google Scholar 

  19. Noguchi S, Noguchi A, Murakami N (1970) Papillary carcinoma of the thyroid. The value of prophylactic lymph node excision. Cancer 26: 1061–1064

    CAS  PubMed  Google Scholar 

  20. Rettenbacher L, Sungler P, Gmeiner D, Kässmann H, Galvan G (2000) Detecting the sentinel lymph node in patients with differentiated thyroid carcinoma. Eur J Nucl Med 27: 1399–1401

    Article  CAS  PubMed  Google Scholar 

  21. Sanders LE, Cady B (1998) Differentiated thyroid cancer. Reexamination of risk groups and outcome of treatment. Arch Surg 133: 419–425

    CAS  PubMed  Google Scholar 

  22. Scheumann GFW, Gimm O, Wegener G, Hundeshagen H, Dralle H (1994) Prognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer. World J Surg 18: 559–567

    CAS  PubMed  Google Scholar 

  23. Sellers M, Beenken S, Blankenship A, Soong SJ, Turbat-Herrera E, Urist M, Maddox W (1992) Prognostic significance of cervical lymph node metastases in differentiated thyroid cancer. Am J Surg 164: 578–581

    CAS  PubMed  Google Scholar 

  24. Shaha AR (1998) Management of the neck in thyroid cancer. Otolaryngol Clin North Am 31: 823–831

    CAS  PubMed  Google Scholar 

  25. Sherman SL, Brierley JD, Sperling M, Ain KB, Bigos ST, Cooper DS, Haugen BR, Ho M, Ladenson PW, Robbins J, Ross DS, Specker B, Taylor T, Maxxon HR (1998) Prospective multicenter study of thyroid carcinoma treatment. Cancer 83: 1012–1021

    Article  CAS  PubMed  Google Scholar 

  26. Shoaib T, Soutar DS, Prosser JE, Dunaway DJ, Gray HW, McCurrach GM, Bessent RG, Robertson AG, Oliver R, MacDonald DG (1999) A suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck. Head Neck 21: 728–733

    CAS  PubMed  Google Scholar 

  27. Stoeckli SJ, Pfaltz M, Steinert H, Schmid S (2002) Histopathological features of occult metastasis detected by sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma. Laryngoscope 112: 111–115

    PubMed  Google Scholar 

  28. Stoeckli SJ, Steinert H, Pfaltz M, Schmid S (2001) Sentinel lymph node evaluation in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 125: 221–226

    Article  CAS  PubMed  Google Scholar 

  29. Tennvall J, Biorklund A, Moller T, Ranstam J, Akerman M (1998) Is the EORTC prognosis index of thyroid cancer valid in differentiated thyroid carcinoma?: a retrospective multivariate analysis of differentiated thyroid carcinoma with long follow-up. Cancer 57: 1405–1414

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Frauenklinikstrasse 24, 8091 , Zurich, Switzerland

    Sandro J. Stoeckli & Stephan Schmid

  2. Department of Pathology, University Hospital, Zurich, Switzerland

    Madeleine Pfaltz

  3. Division of Nuclear Medicine, University Hospital, Zurich, Switzerland

    Hans Steinert

Authors
  1. Sandro J. Stoeckli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Madeleine Pfaltz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hans Steinert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephan Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandro J. Stoeckli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stoeckli, S.J., Pfaltz, M., Steinert, H. et al. Sentinel lymph node biopsy in thyroid tumors: a pilot study. Eur Arch Otorhinolaryngol 260, 364–368 (2003). https://doi.org/10.1007/s00405-003-0594-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-003-0594-y

Keywords

Search

Navigation