Minimally invasive treatments for Metastatic Lymph Nodes in the Neck from Papillary thyroid carcinoma

3-4 October 2014 Naples, Italy Multi disciplinary Conference on Hepatocellular Carcinoma Museo Diocesano www.epatocarcinomacampania.com Background Thyroid cancer represents the most common cancer of the endocrine system. In 2014, 62,980 new cases and 1,890 deaths are estimated to occur in the United Sates. Thyroid cancer occurs more frequently in women than in men, and represents 5% of estimated new cancer in women. Papillary carcinoma is the most frequent among thyroid cancers subtypes, accounting for about 85% of all thyroid cancers1-3. The most common clinical presentation of thyroid cancer is a thyroid nodule, either solitary or within a multinodular goiter. Thyroid ultrasound is now widely available and affordable and allows to identify and follow thyroid nodules, assess neck lymph nodes status, and guide fine needle aspiration for precise diagnosis. Once diagnosed, the treatment of papillary thyroid carcinoma is based on total thyroidectomy, generally associated with central neck dissection. In case disease is present in the lateral neck compartment pre-operatively, lateral neck dissection is generally performed at the time of thyroidectomy, while the role of prophylactic neck dissection is still debated4–7. Following surgery, radioidine ablation is often performed in order to destroy any remaining normal thyroid tissue and any occult microcarcinoma 8,9. Unfortunately, after treatment cervical nodal recurrence may occur in up to 30% of patients10,11. Thus, a strict follow-up is crucial after surgery in patients treated for papillary thyroid carcinoma. Currently, follow-up is mainly based on serial serum thyroglobulin (Tg) measurements and neck US to search for local recurrence or development of cervical lymph nodes metastases4,5,12. Radioiodine 131 scan may be helpful in identifying residual disease, and, in Minimally invasive treatments for Metastatic Lymph Nodes in the Neck from Papillary thyroid carcinoma