LAUSR

The incidence of papillary thyroid cancer has progressively and dramatically increased in the last 3 decades, mostly due to increased detection of papillary thyroid microcarcinoma (mPTC) and the introduction of cancer screening programs [1, 2]. According to World Health Organization Classification of Thyroid Tumors, mPTC refers to small thyroid carcinomas ≤ 10 mm in maximum diameter. They could be distinguished in presurgical and postsurgical detection [3, 4]. mPTCs are found approximately in 6–36% of the population at autopsy. Most of them remain clinically silent and only a small number (2%) progresses [5]. Despite the very low mortality rates, loco regional recurrence is a common clinical problem. Some mPTC have lymph node metastases (16–64%) and multiple tumor localizations (23–33%) at presentation, which are both associated with distant metastases and a less favorable outcome, including increased mortality [5]. For this heterogeneous behavior the follow-up and the management of mPTC patients is different, depending on the risk stratification [6]. Here, we report the case of a mediastinal lymph node metastases 6 years after latero-cervical lymph node dissection for metastases from undiagnosed occult PTC [7].