Thyroid carcinoma presenting as a metastasis to the parapharyngeal space

Indications and extent of central neck dissection for papillary thyroid cancer: An American Head and Neck Society Consensus Statement

“…The prelaryngeal, pretracheal, and paratracheal (left and right) nodes are most commonly involved with PTC. Metastases to the retropharyngeal or retroesophageal nodes are less common . Mediastinal lymph nodes located inferior to the innominate artery and caudal to the brachiocephalic vein are rarely involved in patients with existing central compartment lymph node metastases (Table ) …”

Management of Recurrent/Persistent Nodal Disease in Patients with Differentiated Thyroid Cancer: A Critical Review of the Risks and Benefits of Surgical Intervention Versus Active Surveillance

“…These nodes are rarely involved in DTC recurrences or, even more rarely, upon the initial presentation of disease (72)(73)(74). The retropharyngeal space communicates with the parapharyngeal space through a dehiscence of the superior constrictor muscle fascia, thus potentially permitting the spread of metastatic tumor from the retropharyngeal space into the parapharyngeal space, especially in patients with tumors in the superior pole of the thyroid (75).…”

Technical refinement of ultrasound‐guided transoral resection of parapharyngeal/retropharyngeal thyroid carcinoma metastases

“…Rarely, the lateral retropharyngeal and parapharyngeal lymph nodes are involved in thyroid cancer recurrences or, even more rarely, upon initial presentation of thyroid cancer. 3,8,9 A possible anatomic explanation for this phenomenon has been proposed, and may be attributable to a direct lymphatic route from the thyroid gland to retropharyngeal lymph nodes that has been previously observed. 10 The retropharyngeal space communicates with the parapharyngeal space through a dehiscence of the superior constrictor muscle fascia, thus potentially permitting the spread of metastatic tumor from the retropharyngeal space into the parapharyngeal space.…”