Objectives: Retropharyngeal lymph node metastasis from papillary thyroid carcinoma is uncommon. Traditional extirpative procedures include cervical, cervical-parotid, and transmandibular approaches. The authors report the case of a patient with a retropharyngeal node metastasis originating from papillary carcinoma of the thyroid gland that was successfully removed by a transoral approach.
Method: A 49-year-old man presented for removal of a retropharyngeal lymph node metastasis measuring 21 mm x 27 mm from papillary thyroid carcinoma. Surgical excision was performed through a transoral approach using a surgical navigation system to assess the location of the node precisely.
Result: The postoperative course was uneventful with return to a normal diet on the first postoperative day and hospital discharge on the second postoperative day. Three months after surgery, TSH-stimulated thyroglobulin was undetectable.
Conclusion: The transoral approach to retropharyngeal space is a reliable procedure with low morbidity compared to other approaches. The limited surgical access provided by this approach should limit its use to removal of well-circumscribed lesions not invading adjacent structures.
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