{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:24:11Z","timestamp":1777962251417,"version":"3.51.4"},"reference-count":27,"publisher":"Ordem dos Medicos","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Introduction: The prevalence of retropharyngeal lymph node metastases in papillary thyroid carcinoma is low. The objective of this retrospective study was to assess our institutional experience with the management of such metastases and to compare results with other published series.Methods: We conducted a retrospective analysis of patients diagnosed with papillary thyroid carcinoma and retropharyngeal lymph node metastases who were followed at the Endocrinology Department of the Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil. To identify published cases in the literature, a comprehensive search was conducted using the Medline and PubMed databases from January 1970 to June 2025.Results: We have identified a total of 15 patients. Twelve (80.0%) were women. The median age at initial surgery was 55.7 years (range 20.6 - 84.0 years) and the median duration of follow-up was 9.8 years (range 0.5 - 36.3 years). Five patients (33.3%) were diagnosed with retropharyngeal lymph node metastases during initial tumor staging and 10 (66.7%) in the follow-up, in eight patients (80.0%) due to biochemical persistence of the disease, and in two (20.0%) after cervical lymph node recurrence. Of the 15 patients, seven (46.7%) received no treatment for retropharyngeal lymph node metastases (surveillance group), and eight (53.3%) were treated (therapy group) and, from these, four (26.7%) underwent surgery, two (13.3%) received radiotherapy, one (6.7%) underwent radiosurgery and one (6.7%) underwent both surgery and radiotherapy.Conclusion: Most patients with retropharyngeal lymph node metastases are diagnosed post-thyroidectomy, due to biochemical persistence of the disease or cervical lymphatic recurrence. Retropharyngeal lymph node metastases are commonly single and located ipsilaterally to the primary tumor and co-occur frequently with distant metastases.<\/jats:p>","DOI":"10.20344\/amp.22908","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:47:57Z","timestamp":1760104077000},"source":"Crossref","is-referenced-by-count":1,"title":["Retropharyngeal Lymph Node Metastases in Papillary Thyroid Carcinoma: A Case Series and Literature Review"],"prefix":"10.20344","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2090-7390","authenticated-orcid":false,"given":"Henrique","family":"Pina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9486-9791","authenticated-orcid":false,"given":"Daniela","family":"Cavaco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2035-6228","authenticated-orcid":false,"given":"Ricardo","family":"Nogueira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5479-7332","authenticated-orcid":false,"given":"Valeriano","family":"Leite","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8464","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"10687","doi-asserted-by":"crossref","unstructured":"Randolph GW, Duh QY, Heller KS, LiVolsi VA, Mandel SJ, Steward DL, et al. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid. 2012;22:1144-52.","DOI":"10.1089\/thy.2012.0043"},{"key":"10688","doi-asserted-by":"crossref","unstructured":"Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1-133.","DOI":"10.1089\/thy.2015.0020"},{"key":"10689","doi-asserted-by":"crossref","unstructured":"Adam MA, Pura J, Goffredo P, Dinan MA, Reed SD, Scheri RP, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J Clin Oncol. 2015;33:2370-5.","DOI":"10.1200\/JCO.2014.59.8391"},{"key":"10690","doi-asserted-by":"crossref","unstructured":"Sandler ML, Xing MH, Levy JC, Chai RL, Khorsandi AS, Gonzalez-Velazquez C, et al. 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;43:1331-44.","DOI":"10.1002\/hed.26572"},{"key":"10691","doi-asserted-by":"crossref","unstructured":"Harries V, McGill M, Tuttle RM, Shaha AR, Wong RJ, Shah JP, et al. Management of retropharyngeal lymph node metastases in differentiated thyroid carcinoma. Thyroid. 2020;30:688-95.","DOI":"10.1089\/thy.2019.0359"},{"key":"10692","doi-asserted-by":"crossref","unstructured":"McCormack KR, Sheline GE. Retropharyngeal spread of carcinoma of the thyroid. Cancer. 1970;26:1366-9.","DOI":"10.1002\/1097-0142(197012)26:6<1366::AID-CNCR2820260627>3.0.CO;2-V"},{"key":"10693","doi-asserted-by":"crossref","unstructured":"Debnam JM, Guha-Thakurta N. Retropharyngeal and prevertebral spaces: anatomic imaging and diagnosis. Otolaryngol Clin North Am. 2012;45:1293-310.","DOI":"10.1016\/j.otc.2012.08.004"},{"key":"10694","unstructured":"Zhao J, Zheng W, Zhong M, Daming L, Guo L. Risk factors and prognosis of retropharyngeal lymph node metastasis from papillary thyroid carcinoma. Altern Ther Health Med. 2024;30:474-9."},{"key":"10695","doi-asserted-by":"crossref","unstructured":"Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The eighth edition AJCC cancer staging manual: Continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging. 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