Lymph node metastasis bilateral papillary thyroid microcarcinoma and surgical management / 中国医师进修杂志

ABSTRACT

Objective To analyse the frequeney and pattern of lymph node metastasis in bilateral papillary thyroid microcarcinoma (PTMC), and establish the optimal surgical strategy for patients. Methods From March 2006 to August 2008, 58 bilateral PTMC patients received surgical treatment and the tumour characteristics, the frequency and pattern of lymph node metastasis and surgical management of these patients were retrospectively analysed. Results Forty-four patients received total thyroideetomy and 14 patients received near-totsl thyroideetomy, 47 patients received central compartment (level VI ) dissection and cervical level Ⅱ,Ⅲ, IV node exploration by internal jugular vein exposure,10 patients received level Ⅵdissection and unilateral cervical dissection and 1 patient received bilateral cervical dissection. The mean tumor diameter was (6.28 + 2.23) mm and 26 patients (44.8%) had node involvement, 88.5%(23/26) pa-tients had only level Ⅵ node involvement. Only 1 patient had node involvement in the jugular chain without level Ⅵ node involvement, 2 patients with level Ⅵ node involvement were associated with another cervical compartment nodes involvement. Conclusions Bilateral PTMC has high incidence of lymph node metasta-sis. The cervical level Ⅵ is the most common site of node involvement for bilateral PTMC and the surgical strategy for bilateral PTMC should include the cervical level Ⅵ dissection routinely.