Medical Science
Volume 24, Issue 105, September - October, 2020
Efficacy of neck ultrasound in the detection of cervical lymph node metastasis from thyroid carcinoma
Ibrahim Khaled Ibrahim Raslan1♦, Mahmoud Saad Farahat1, Ahmed Serag Eldin Hessein1, Nafissa El-badawy2, Amr Mahmoud Abd-Elsamad3, Mahmoud Ahmed El-shafie1
1General surgery department,Faculty of Medicine, Ain shams University, Cairo, Egypt
2Pathology department, Faculty of Medicine, Ain shams University, Cairo, Egypt
3Radiology department, Faculty of Medicine, Ain shams University, Cairo, Egypt
♦Corresponding author
General surgery department, Faculty of Medicine, Ain shams University,
Cairo, Egypt;
Email: dribrahimkhaled@med.asu.edu.eg
ABSTRACT
Background: In patients with proven thyroid carcinoma, neck metastases are often occult on routine physical examination. Both the
central and lateral neck compartments can harbor non palpable, occult metastases. our study was done to assess the diagnostic
accuracy of preoperative neck ultrasound (US) in the detection of both central and lateral cervical lymph node metastases from
thyroid carcinoma so that it can help in tailoring the surgical treatment plan. Patients and methods: The study was conducted at the
General Surgery Department of Ain shams University Hospital from December 2017 through December 2019. It included 40 patients
who had proved thyroid carcinoma by preoperative histopathology. Preoperative Neck ultrasound was done for all patients to
detect suspicious Lymph Nodes. Total thyroidectomy with central neck dissection+/- Lateral neck dissection according to ultrasound
results was done. The accuracy of US was assessed according to whether the removed lymph nodes had histologically confirmed
malignancy or not. Results: The sensitivity and specificity of US in predicting thyroid carcinoma metastasis in the central neck were
13.3% and 90%, respectively. The sensitivity and specificity of US in predicting metastasis in the lateral neck were 90.9% and 85.7%,
respectively. Also ultrasound detected occult non palpable lateral neck metastasis in 47.5% of patients. Conclusion: Preoperative
neck US is a valuable tool in assessing patients with thyroid cancers. The highly sensitive and specific nature of US in predicting
cervical lymph node metastasis in the lateral neck can provide reliable information to assist in surgical management.
Keywords: Thyroid carcinoma, Neck dissection, Neck Ultrasound, Lymph nodes
Medical Science, 2020, 24(105), 3083-3092
