Metastases of papillary thyroid cancer into axillary lymph nodes: a rear clinical case presentation and literature review
Abstract
Thyroid cancer (TC) is the most common endocrine tumor. Papillary TC is the most frequently met form of TC. Usually, papillary TC spreads into groups II–VI of cervical lymph nodes, whereas, in a typical papillary TC patient, metastases into axillary lymph nodes are a rare finding. An adequate surgery and iodine radiotherapy, when indicated, allows for a good prognosis in the majority of such patients. Clinical case. A female patient, 87 years of age, was admitted to our Clinic with a diagnosed axillary lymph node metastasis. Thirty two year earlier, she underwent thyroid and central lymph node removal due to a papillary TC. Since then, she received three cycles of radioactive iodine therapy. At the time of admission, the patient manifested with axillary lymphadenopathy on the right side, occipital lymphadenopathy, and multiple metastatic foci in the lungs. We performed removal of occipital and right axillary lymph nodes. Pathological evaluation demonstrated metastatic papillary TC in all lymph node group removed. The patient was administered another cycle of iodide radiotherapy. The patient died of the metastatic process in the lungs 18 months later. Thus, the follow up period in this patient since the moment of TC initial diagnosis until she succumbed was 32.5 years. Usually, TC patients have a considerable life span after surgery and iodide radiotherapy. TC spreads most often into cervical and mediastinal lymph nodes. However, atypical metastases into axillary lymph nodes may occur as late as 32 years after the first surgical intervention, which necessitates a life-long follow up by an oncologist.
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