Axillary lymph node metastasis in papillary thyroid cancer patient: a case report

  • Introduction: Thyroid cancer (T?) is the most common endocrine malignancy. The most frequent type of TC is papillary carcinoma. Typically papillary TC metastases have more often cervical location in II-VI neck lymph nodes groups. Axillary metastasis is not a common finding in the classic type of papillary carcinoma. Adequate Surgery and radioiodine therapy, if necessary, provide for excellent prognosis of 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). 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. Patient received 131-I therapy one more. 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. Asa ruleapapillary 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.  


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