Axillary lymph node recurrence of papillary thyroid microcarcinoma: report of a case

• Published in: Surgery today (Tokyo, Japan) Vol. 34; no. 5; pp. 440 - 443
• Main Authors: Koike, Kenta, Fujii, Teruhiko, Yanaga, Hiroshi, Nakagawa, Shino, Yokoyama, Goro, Yahara, Toshiro, Hanzawa, Mai, Kato, Seiya, Shirouzu, Kazuo
• Format: Journal Article
• Language: English
• Published: Japan 01.05.2004
• Subjects: Axilla; Carcinoma, Papillary - secondary; Carcinoma, Papillary - surgery; Female; Humans; Lymph Node Excision; Lymph Nodes - pathology; Lymphatic Metastasis; Middle Aged; Neoplasm Recurrence, Local - surgery; Reoperation; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-003-2735-8

We report a case of axillary lymph node recurrence of thyroid papillary microcarcinoma (PMC) in a 51-year-old woman who had undergone thyroidectomy with lymph node dissection 5 years earlier. We performed residual thyroid resection with cervical and bilateral axillary lymph node dissection, and pathological examination revealed well-differentiated papillary carcinoma, with partial poor differentiation. Postoperative radioiodine therapy was ineffective, and the patient died of systemic dissemination of the recurrence 8 months after her second operation. The positive cell rates of proliferating cell nuclear antigen and Ki-67 were clearly higher in the recurrent lymph nodes than in the primary thyroid tumor, suggesting increased cell proliferation in the recurrent lymph nodes. Thyroid papillary carcinoma rarely recurs in the axillary lymph nodes, but its possibility must be kept in mind, especially in patients with remarkable cervical lymph node metastasis and those who undergo extensive lymph node dissection.