Incidental cervical lymph node metastasis of papillary thyroid cancer in neck dissection specimens from a tongue squamou
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CASE REPORT
Incidental cervical lymph node metastasis of papillary thyroid cancer in neck dissection specimens from a tongue squamous cell carcinoma patient: a case report Naomi Ishibashi-Kanno 1 Hiroki Bukawa 1
&
Kenji Yamagata 1 & Satoshi Fukuzawa 1 & Fumihiko Uchida 1 & Toru Yanagawa 1,2 &
Received: 10 May 2020 / Accepted: 11 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract We report a rare case of lymph node metastasis of papillary thyroid cancer (PTC) incidentally detected in a neck dissection specimen of tongue squamous cell carcinoma (SCC). A 42-year-old Japanese woman was diagnosed with tongue SCC (T1N0M0, Stage I). Partial glossectomy with supraomohyoid neck dissection was performed under general anesthesia, and histopathological examinations revealed primary SCC of the tongue and neck metastasis of PTC in neck dissection specimens. A few months later, total thyroidectomy and left modified radical neck dissection were performed by thyroid surgeons. The histopathological diagnosis was PTC of both the thyroid glands. There was no evidence of tumor recurrence or distant metastasis at the 9-month follow-up. Keywords Papillary thyroid cancer . Squamous cell carcinoma . Tongue cancer . Lymph node metastasis . Incidentally
Introduction Patients with oral cancer have a relatively high frequency of multiple primary cancers in other organs [1, 2]. These cancers mostly occur in the upper gastrointestinal tract region; however, many cases have been reported in other body parts. Diagnosing the presence or absence of double cancer before oral cancer treatment is important for the prognosis of patients [3]. Occult papillary thyroid cancer (PTC) has been reported in up to 10% of the general population and in 8–35% of autopsy studies [4]. Some occult thyroid cancer cases have been found incidentally during the postoperative pathological diagnosis of another aggressive malignancy such as head and neck cancer [5–10].
* Naomi Ishibashi-Kanno [email protected] 1
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba Ibaraki 305-8575 Japan
2
Department of Oral and Maxillofacial Surgery, Ibaraki Prefectural Central Hospital, Koibuchi 6528, Kasama Ibaraki 309-1793 Japan
Here, we report about lymph node (LN) metastasis of PTC that was found incidentally in a neck dissection specimen of tongue squamous cell carcinoma (SCC).
Case report A 42-year-old Japanese woman was referred to the Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital. She complained of a painful ulcer in the left region of her tongue for 10 months. She had no medical history. Intraoral examination revealed a mass measuring 10 × 6 × 4 mm in the left region of her tongue (Fig. 1). The mass showed painful ulceration and induration. An extraoral examination found no evidence of swelling, tenderness, or lymphadenopathy. Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) findings identified mild lymphadenopathy,
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