Lateral Neck Sentinel Lymph Node Biopsy(LSLNB)in PTC
Lateral Neck Sentinel Lymph Node Biopsy(LSLNB)in PTC
Objective: To investigate the incidence of lateral neck node occult metastasis and to show
 the usefulness of sentinel lymph node biopsy (SLNB) in the detection of lateral neck node
 metastasis in thyroid carcinoma, the investigators used a radioisotope to detect the sentinel
 lymph node.

 Summary Background Data: Although occult lymph node metastasis to the lateral neck
 compartment is common in papillary thyroid carcinoma, the incidence and patterns of lateral
 neck node metastasis in papillary carcinoma are not known.
On the day of the operation, patients underwent preoperative lymphoscintigraphy after the
 intratumoral injection of a Tc-99m phytate 1 mCi in 0.1-0.2 mL 0.9% NaCl under
 ultrasonographic guidance. Total thyroidectomy or lobectomy with central neck dissection
 preceded SLN detection to avoid interference by primary tumor radioactivity. After total
 thyroidectomy or lobectomy, the dissections were performed toward the internal jugular chain
 beneath the sternocleidomastoid muscle. A handheld, collimated gamma probe and
 lymphoscintigraphy were used to scan the lateral compartments (through skin and under the
 SCM) for "radioactive" lymph nodes. Removed SLNs were submitted immediately for frozen
 biopsy. If any of the SLNs were positive for metastasis on the frozen sections, MRND was
 performed immediately. In cases for which the frozen section was negative but the final
 pathology report detailed microscopic positivity in the lateral sentinel nodes, RAI ablations
 were performed without additional MRND.
Inclusion Criteria:

 -  Cases with tumors larger than 1 cm in size or with suspicious central neck node
 metastasis in Papillary thyroid cancer

 Exclusion Criteria:

 -  The patient with definite metastatic lymph node in lateral neck compartment