A solid-pseudopapillary tumor (SPT) of the pancreas is known as a low grade malignant tumor with a good prognosis; therefore, surgical intervention is necessary. A 14-year-old boy presented with a large pancreatic SPT and three hepatic metastases. The patient and his family refused surgery. Two serial follow-up CT scans over a period of 13 years demonstrated almost complete disappearance of the pancreatic tumor and three hepatic metastases without relevant treatment. Although there have been a few reports of spontaneous healing of SPT, there has been no report regarding spontaneous disappearance of SPT and distant metastasis. Herein, we report on the spontaneous regression of a large SPT and the disappearance of three hepatic metastases.
Adolescent ; Carcinoma, Papillary/radiography/*secondary ; Humans ; Liver Neoplasms/radiography/*secondary ; Male ; Pancreatic Neoplasms/*pathology/radiography ; Remission, Spontaneous ; Tomography, X-Ray Computed

Ectopic thyroid glands generally occur in the midline as a result of abnormal median migration, and their presence lateral to the midline is rare. We present one case of an ectopic thyroid gland masquerading as a lateral neck metastasis of a papillary thyroid carcinoma (PTC). In this case of a 54-yr-old woman with left PTC, we suspected left lateral neck metastasis on preoperative neck computed tomography. The patient underwent total thyroidectomy, central compartment neck dissection, and left modified radical neck dissection (MRND). The patient was diagnosed as having an accessory thyroid gland on the lateral neck on the final pathologic report. Surgeons should be aware of the existence of an ectopic thyroid gland in unusual locations.
Biopsy ; Carcinoma, Papillary/radiography/*secondary ; Choristoma/*pathology/radiography ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neck ; *Thyroid Gland ; Thyroid Neoplasms/*pathology/radiography ; Tomography, X-Ray Computed

OBJECTIVETo discuss the evaluation of elective neck dissection (END) for the cN(0) patients with papillary thyroid carcinoma (PTC).

METHODSBy analyzing the recurrent and metastatic region (thyroid, group VI lymph nodes, lateral neck region, beyond neck) of 139 PTC patients treated secondly in our hospital, group VI lymph nodal metastasis is divided into recurrence of primary site and distinguished from lateral neck lymph nodes. The clinical value of END for cN(0) PTC patients is also retrospectively analyzed.

RESULTSThyroidal recurrence accounts for 83% (73/88). Level VI metastasis accounts for 76% (67/88), 17 patients have received END and account for 65% (17/26). Metastasis to lateral neck lymph nodes account for 17% (17/98), among these patients, 5 patients have received END and account for 19% (5/26).

CONCLUSIONSFor the patients with cN(0) PTC, ipsilateral thyroid lobectomy plus level VI dissection is recommended and lateral END (level II-V) is not supported. For the patients with cN(0) but UB N(+) and/or CT N(+), lateral END (level II-V) is recommended. The necessity of CT examination in the diagnosis and treatment of thyroid cancer should be emphasized.

Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; diagnostic imaging ; secondary ; surgery ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Radiography ; Reoperation ; Retrospective Studies ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; surgery ; Thyroidectomy ; methods