Abstract

RUAN, Lingling; ZHANG, Qingxin  and  QU, Qinghong. The sonographic features of preoperative ultrasonography of metastatic tumors of thyroid cancer confirmed by surgical pathology. Invest. clín [online]. 2023, vol.64, n.2, pp.173-183.  Epub Sep 08, 2023. ISSN 0535-5133.  https://doi.org/10.54817/ic.v64n2a04.

This study aimed to analyze the sonographic features of metastatic tumors in patients with thyroid cancer that underwent preoperative ultrasonography. One hundred and three thyroid cancer patients whose metastases were confirmed by surgical pathology in The First People’s Hospital of Wenling from January 2020 to December 2021 were enrolled. All patients received preoperative ultrasound examinations, and the sonographic features were analyzed. Ultrasound examination showed 83.50% of cervical lymph node metastasis (CLNM), 24.27% of soft tissue invasion (STI), 3.88% of distant organ metastasis (DOM), 8.74% of CLNM + STI, 0.97% of CLNM + DOM, and 0.97% of CLNM + STI+DOM. Unilateral CLNM accounted for 72.09%, while bilateral CLNM accounted for 27.91%. The mean long diameter of metastatic lymph nodes was (1.83±0.63) cm, and the mean short diameter was (1.03±0.42) cm. Metastases to zone II, III, IV, V, VI, and VII accounted for 8.14%, 48.84%, 23.26%, 4.65%, 11.63%, and 3.49%, respectively. The L/T ratio of lymph nodes in 65 cases was lower than 2; 45 of 70 solid metastases exhibited solid hyperechoic, 15 multifocal hyperechoic, seven unifocal hyperechoic, and three diffusely distributed solid hyperechoic images. There were 25 patients with STI that experienced invasion of the thyroid capsule, ten patients experienced the invasion of the cervical fatty muscles, two patients had invasion of the trachea, and one patient had invasion of the thyroid cartilage. Of the four patients with DOM, one had parotid metastasis, one had submandibular metastasis, one had axillary metastasis, and one had uterine metastasis. The most common metastatic sites of thyroid cancer are cervical lymph nodes. However, there were also metastases in the soft tissues and distant organs. The ultrasonography exhibited typical sonographic features. An adequate familiarity with these sonographic features can aid in detecting suspicious metastases in time, which is crucial to the clinical diagnosis, treatment, and prognostic assessment.

Keywords : surgical pathology; thyroid cancer; metastatic lesions; ultrasonography; sonographic features.

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