Review of retropharyngeal and parapharyngeal nodal metastasis of papillary thyroid carcinoma

Background

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. In rare instances, PTC has metastasized to the retropharyngeal and parapharyngeal nodes. This is hypothesized to occur due to an aberrant lymphatic channel or via retrograde lymphatic flow following previous neck dissection. Methods: A literature search was conducted with keywords “parapharyngeal,” “retropharyngeal,” and “papillary thyroid carcinoma.” Results: 46 articles were identified for a total of 135 cases. The most common presenting symptom was lymphadenopathy followed by pharyngeal mass and dyspnea. 38.03 % of patients were asymptomatic. Of cases including initial treatment history, 94.44 % had a history of neck dissection. The transcervical approach was the most utilized to resect the tumors, although in recent years trans-oral robotic surgery (TORS) has also been used.

Conclusion

PTC metastatic to the retropharyngeal and parapharyngeal nodes is a rare occurrence that can be difficult to diagnose due its indolent nature.