Metastatic thyroid carcinoma to the parapharyngeal and retropharyngeal spaces: Systematic review with seven newly reported cases describing an uncommon presentation of a common disease

Head Neck. 2021 Apr;43(4):1331-1344. doi: 10.1002/hed.26572. Epub 2020 Dec 9.

Abstract

Background: Metastatic thyroid carcinoma to retropharyngeal and parapharyngeal (RP/PP) lymph nodes is rare. Literature suggests previous lateral neck dissection (LND) may alter patterns of lymphatic drainage in the neck, predisposing to these less common sites of spread.

Methods: PRISMA-guided systematic search for all published cases detailing RP/PP metastases of well-differentiated thyroid carcinoma from 1970 to 2019.

Results: Seventy articles were identified and 44 were included, along with seven cases treated at our institution, totaling 239 cases. Cases represented both retropharyngeal (60.7%) and parapharyngeal (39.3%) metastases identified in the initial (27.6%) and recurrent (72.4%) setting.

Conclusion: RP/PP metastases generally present in the recurrent setting. RP/PP metastases often represent high-risk disease, and surgical treatment is recommended.

Keywords: metastasis; papillary thyroid cancer; parapharyngeal space; retropharyngeal space; well-differentiated thyroid cancer.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Papillary* / surgery
  • Humans
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Neck Dissection
  • Thyroid Neoplasms* / surgery