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Abstract
Introduction: thyroid cancer (ТС) is the most common endocrine malignancy. Typical and frequent type of TC is papillary carcinoma (PC). Metastases of papillary TC have more often cervical location in II-VI neck lymph nodes groups. Axillary metastasis is not a common finding in the classic type of PC. Adequate Surgery and radioiodine therapy, if necessary, provide the excellent prognosis for most papillary TC patients. Case presentation. 87-year-old woman was presented in our Center with metastatic axillary lymphadenopathy. She had a history of thyroidectomy with central neck dissection 31 years ago for papillary TC. Earlier she underwent right and left lateral neck dissection and 131-I therapy (3 times: after 6 months - 86 mCi, after 12 months- 92 mCi, after 24 months - 98 mCi). On the time of patient presentation in the Center we have found right axillary lymphadenopathy, occipital lymphadenopathy and multiple pulmonary metastases. In our clinic we have performed removal of occipital lymph node metastases and right axillary metastases dissection. Postoperative pathology report has shown infiltration of the cervical and axillary lymph nodes by metastatic papillary TC. After Surgery patient received 131-I therapy one more again (after 3 months - 110 mCi, after 9 months - 150 mCi). Unfortunately, she died after 18 months later. The reason of death was progression of distant metastases at lungs. Follow up period from the initial operation made 32.5 years. Conclusion and discussion. Papillary thyroid cancer patient’s progression free survival is more 10 years. As a rule a papillary TC patients has survived for many years after the initial surgery. Exclusively rarely TC metastases can emerge in different atypical places and in the axillary lymph nodes also (more than 31 years after initial Surgery) that maybe associated with a poor prognosis. Case report is unique, because there are 16 equal clinical cases in world literature.
References
Society American Cancer Cancer Facts & Figures 2017. - Atlanta: American Cancer Society, 2017.
Dy B.D., Shaha A.R. Philosophy on Neck Dissection in Thyroid Cancer-Current Controversies and Consensus // Indian Journal of Surgical Oncology. - 2018. - Vol. 9. - P. 2-5.
Davies L., Welch H.G. Increasing incidence of thyroid cancer in the United States, 1973-2002. // J Am Med Assoc. - 2006. - Vol. 295. - P. 2164-2167.
Park S., Oh C.M., Cho H. et al. Association between screening and the thyroid cancer "epidemic" in South Korea: evidence from a nationwide study // BMJ. -2016. - Vol. 30. - P. 5747.
Howlader N., Noone A.M., Krapcho M. et al. SEER Cancer Statistics Review, 1975-2010. - Bethesda: National Cancer Institute, 2013.
Wang L.Y, Palmer F.L., Nixon I.J. et al. Multi-organ distant metastases confer worse disease-specific survival in differentiated Thyroid cancer // Thyroid. - 2014. - Vol. 24. - P. 1594-1599.
So YK., Kim M-J., Kim S., Son Y-I. Lateral lymph node metastasis in papillary thyroid carcinoma: A systematic review and meta-analysis for prevalence, risk factors, and location // International Journal of Surgery. - 2018. - Vol. 50. - P. 94-103.
Rosenbaum M.A., McHenry C.R. Contemporary management of papillary carcinoma of the thyroid gland. // Expert Rev Anticancer Ther. - 2009. - Vol. 9. - P. 317-329.
Kim H.I., Kim T.H., Choe J.H. Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis // Br J Surg. -2018. - Vol. 105. -P. 270-278.
Lee YM., Sung TY, Kim W.B. Risk factors for recurrence in patients with papillary thyroid carcinoma undergoing modified radical neck dissection // Br J Surg. - 2016. -Vol. 103. - P. 1020-1025.
Lin D.Z., Qu N., Shi R.L. et al. Risk prediction and clinical model building for lymph node metastasis in papillary thyroid microcarcinoma // Onco Targets Ther. - 2016. - Vol. 9. - P. 5307-5316.
Salter K.D., Andersen P.E., Cohen J.I. et al. Central nodal metastases in papillary thyroid carcinoma based on tumor histologic type and focality // Arch Otolaryngol Head Neck Surg. - 2010. - Vol. 136. - P. 692-696.
Thompson A.M., Turner R.M., Hayen A. et al. A preoperative nomogram for the prediction of ipsilateral central compartment lymph node metastases in papillary Thyroid cancer // Thyroid. - 2014. - Vol. 24. - P. 675682.
Kwak J.Y, Kim E.K., Kim M.J. et al. Papillary microcarcinoma of the thyroid: predicting factors of lateral neck node metastasis // Ann Surg Oncol. - 2009. - Vol. 16. - P. 1348-1355.
Kim YS. Patterns and predictive factors of lateral lymph node metastasis in papillary thyroid microcarcinoma // Otolaryngol Head Neck Surg. - 2012. - Vol. 147. - P. 15-19.
Nam I.C., Park J.O., Joo YH. et al. Pattern and predictive factors of regional lymph node metastasis in papillary thyroid carcinoma: a prospective study // Head Neck. - 2013. - Vol. 35. - P. 40-45.
Yang J., Gong Y, Yan Sh. et al. Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases // Cancer Medicine. - 2016. - Vol. 5. - P. 2161-2168.
Angeles-Angeles A., Chable-Montero F., Martinez-Benitez B., Albores- Saavedra J. Unusual metastases of papillary thyroid carcinoma: Report of 2 cases // Ann Diagn Pathol. -2009. - Vol. 13. - P. 189-196.
Chen S.W., Bennett G., Price G. Axillary lymph node calcificationdue to metastatic papillary carcinoma // Australasian Radiology. - 1998. - Vol. 43. - P. 241-243.
Chiofalo M.G., Losito N.S., Fulciniti F. et al. Axillary node metastasis from differentiated thyroid carcinoma with hurthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings // BMC Cancer. - 2012. - Vol. 12. - P. 55-59.
Damle N., Singh H., Soundararajan R., Bal Ch. et al. Radioiodine Avid Axillary Lymph Node Metastasis in Papillary Thyroid Cancer: Report of a Case // Indian J Surg Oncol. -2011. - Vol. 2. - P. 193-196.
El Khiati R.E., Ouaissi L., Rouadi S. et. al. Metastase axillaire d>un carcinome papillaire de la thyroide: a propos d>un cas // Pan African Medical Journal. - 2013. - Vol. 16. -P. 1-5.
Elboga U., Kalender E., Yilmaz M. et al. Axillary Lymph Node Metastasis of Papillary Thyroid Carcinoma Detected by FDG PET/CT in a Thyroglobulin-Positive Patient With Negative Whole-Body 131I Scan // Clinical Nuclear Medicine. - 2012. - Vol. 37. - P. 1120-1122.
Ers V., Galant C., Malaise J. et al. Axillary lymph node metastasis in recurrence of papillary thyroid carcinoma: A case report // Wien Klin Wochenschr. - 2006. - P. 124-127.
Goyal N., Pakdaman M., Kamani D. et al. Mapping the Distribution of Nodal Metastases in Papillary Thyroid Carcinoma: Where Exactly Are the Nodes? // Laryngoscope. -2017. - Vol. 127. - P. 1959-1964.
Hafez M., Refky B., Abd Elwahab K. et al. Axillary lymph nodes metastasis in a patient with recurrent papillary thyroid cancer: a case report // Journal of Medical Case Reports. - 2015. - Vol. 9. - P. 181-183.
Kamaleshwaran K.K., Rajan F., Mohanan V., Shinto A.S. Rare case of axillary lymph node metastasis in papillary thyroid carcinoma detected using Iodine-131 whole-body scintigraphy and single-photon emission computed tomography/ computed tomography // Indian Journal of Nuclear Medicine. - 2015. - Vol. 30. - P. 168-170.
Kepenekci I., Demirkan A., Cakmak A., Tug T. et al. Axillary Lymph Node Metastasis as a Late Manifestation of Papillary Thyroid Carcinoma // Thyroid. - 2009. - Vol. 19. - P. 417-419.
Koike K., Fujii T., Yanaga H., Nakagawa S. et al. Axillary lymph node recurrence of papillary thyroid microcarcinoma: Report of a case // Surg Today. - 2004. - P. 440-443.
Krishnamurthy A., Vaidhyanathan A. Axillary lymph node metastasis in papillary thyroid carcinoma: Report of a case and review of the literature // J Can Res Ther. -2011. - Vol. 7. - P. 220-222.
Lal G., Ituarte P, Duh QY Clark O. The axilla as a rare site of metastatic thyroid cancer with ominous implications // Abstract. 74th Annual Meeting of ATA. - 2003.
Nakayama H., Wada N., Masudo Y, Rino Y Axillary lymph node metastasis from papillary thyroid carcinoma: Report of a case // Surg Today. - 2007. - Vol. 37. - P. 311-315.
Rouviere H. Anatomy of the human lymphatic system. - Ann Arbor, Michigan, 1938. - P. 318.
Романчишен А.Ф. Хирургия щитовидной и околощитовидных желёз. -Санкт-Петербург: ИПК Вести, 2009. - С. 647.
Матвеева З.С., Романчишен А.Ф., Гостимский А.В., Вабалайте К.В. Профилактическая тиреоидэктомия у детей из семей с синдромами МЭН как метод предупреждения медуллярного рака щитовидной железы // Педиатр. - 2017. - Т. 8. - № 4. - С. 5-11.
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