Papillary thyroid microcarcinoma with contralateral lymphatic skip metastasis and breast cancer: A case report

doi:10.12998/wjcc.v10.i11.3609

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Apr 16, 2022; 10(11): 3609-3614
Published online Apr 16, 2022. doi: 10.12998/wjcc.v10.i11.3609

Papillary thyroid microcarcinoma with contralateral lymphatic skip metastasis and breast cancer: A case report

Min Ding, Ya-Hui Kong, Jian-Hua Gu, Rong-Li Xie, Jian Fei

Min Ding, Jian Fei, Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Ya-Hui Kong, Department of General Surgery, Shanghai Changhang Hospital, Shanghai 200122, China

Jian-Hua Gu, Department of General Surgery, Shanghai Ruijin Rehabilitation Hospital, Shanghai 200023, China

Rong-Li Xie, Department of General Surgery, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China

Author contributions: Ding M reviewed the literature and contributed to data analysis and manuscript drafting; Kong YH and Xie RL were responsible for data collection; Fei J and Gu JH were responsible for the revision of the manuscript, considering and providing important intellectual content; All authors issued final approval for the version to be submitted.

Supported by The Project of Shanghai Municipal Health Commission, No. 20214Y0223.

Informed consent statement: Informed written consent (surgical operation) was obtained from the patient.

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Jian Fei, MD, PhD, Chief Doctor, Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin Road, Huangpu District, Shanghai 200025, China. fj10777@rjh.com.cn

Received: December 29, 2021
Peer-review started: December 29, 2021
First decision: January 25, 2022
Revised: February 3, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 16, 2022
Processing time: 100 Days and 5.3 Hours

Abstract

BACKGROUND

The recognized pattern of cervical lymph node metastasis (CLNM) of papillary thyroid carcinoma involves a stepwise route. Contralateral lymph node skip metastasis is very rare. In addition, the patient in our case report also suffered from a breast carcinoma accompanied by left supraclavicular lymphadenopathy, which made it difficult to distinguish the origin of the CLNM. Based on this case, we recommended that more detailed physical and imaging examinations are needed for patients with uncommon cervical lymphatic metastasis of primary cancer.

CASE SUMMARY

A 53-year-old women was admitted to the hospital for a neck mass in the left cervical region that had existed for 2 mo. The neck mass was suspected to be an enlarged lateral LN originating from papillary thyroid microcarcinoma of the contralateral thyroid lobe, according to ultrasound and ultrasound-guided fine needle aspiration biopsy. The patient underwent total thyroidectomy and radical cervical LN dissection. Postoperative pathology confirmed the diagnosis of papillary thyroid microcarcinoma with contralateral lymphatic skip metastasis. Unfortunately, a breast cancer was discovered 4 mo later, which was accompanied by ipsilateral supraclavicular LN metastasis. She accepted neoadjuvant chemotherapy and subsequent left modified radical mastectomy for treatment. The patient is currently receiving postoperative radiotherapy, and no local recurrence was observed in the 6-mo follow-up after surgery.

CONCLUSION

We present a rare case of papillary thyroid microcarcinoma with contralateral lymphatic skip metastasis and breast cancer with supraclavicular lymphatic metastasis.

Keywords: Thyroid cancer; Papillary; Breast neoplasms; Lymphatic metastasis; Skip metastasis; Contralateral metastasis; Case report

Core Tip: The recognized pattern of cervical lymph node metastasis (CLNM) of papillary thyroid carcinoma involves a stepwise route. Contralateral lymph node skip metastasis is very rare. In addition, the patient in our case report also suffered from a breast carcinoma accompanied by left supraclavicular lymphadenopathy, which made it difficult to distinguish the origin of the CLNM. Based on this case, we recommended that more detailed physical and imaging examinations are needed for patients with uncommon cervical lymphatic metastasis of primary cancer.