Management of retropharyngeal node metastases from thyroid carcinoma.

Background: Lymph node metastases are relatively common in thyroid carcinoma, but retropharyngeal nodes (RPN) are rare. Management may be surgical or non-surgical, according to the context of the disease.

Methods: Systematic review of cases reported in the literature and report of 5 cases.

Results: Most case series report surgical management, via a cervical or transoral approach. RPN was the specific object of 26 case series, with a total of 85 patients, with surgery performed in 22/26 studies. Our 5 cases illustrated various strategies in the multidisciplinary management, with surgery for three patients (also with (131)I in one case), targeted therapy for one patient with concurrent distant metastases, and watch and wait for one elderly patient.

Conclusions: Management of RPN is not always surgical. Discussion of options in a multidisciplinary tumor board setting may optimize care.