Papillary Thyroid Carcinoma Incidentally Found in Cervical Lymph Nodes During Neck Dissection for Patients with Tongue Squamous Cell Carcinoma: A Three-Case Report and Literature Review

Publication date: Available online 20 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Yu-ming Xu, Zhao-jian Gong, Han-jiang Wu

Abstract

The incidence of papillary thyroid carcinoma incidentally found in cervical lymph nodes during neck dissection for patients with tongue squamous cell carcinoma is infrequent, with the coexistence of papillary thyroid carcinoma and squamous cell carcinoma in the same cervical lymph node be the rarest. Some of these patients presented with primary lesion in their thyroid gland, the others have no obviously malignant thyroid lesion. The reasons behind this kind of clinical phenomenon and the relationship between tongue squamous cell carcinoma and papillary thyroid carcinoma found in cervical lymph nodes are unclear. Moreover, for surgeons, it is still a clinical dilemma to make a choice between thyroid surgery and follow-up. Of the 956 patients who underwent neck dissection due to maxillofacial tumors from January 2011 through December 2017 at Second Xiangya Hospital of Central South University, 3 patients with tongue squamous cell carcinoma presented with papillary thyroid carcinoma in their cervical lymph nodes. Neither preoperatively physical examination nor ultrasonography after surgery showed significant nodule in the thyroid gland of these patients, so none of them underwent thyroid surgery or chemoradiotherapy. At follow-up（1 year to 6.5 years）, we found no obviously malignant lesion in their thyroid gland or relatedly metastatic disease. Our study suggests that tongue squamous cell carcinoma may not affect the occurrence and development of papillary thyroid carcinoma in cervical lymph nodes. For patients with tongue squamous cell carcinoma presenting with papillary thyroid carcinoma in cervical lymph nodes, it is not necessary to carry out thyroid surgery immediately if ultrasonography showed no significantly malignant lesion in thyroid gland. Nevertheless, conducting periodic follow-up is very important.

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