Thyroidectomy and Lymph Node Dissection for Highly Differentiated Thyroid Cancer Using a New Cervical Approach: A Clinical Case

Objective: To demonstrate the advantages of using a modified aesthetic surgical approach in performing modified radical neck lymph node dissection and thyroidectomy in a patient diagnosed with papillary thyroid cancer.

Case report: A clinical case of surgical treatment of a 47-year-old female patient who was admitted to the Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 with an confirmed diagnosis of papillary thyroid cancer, staged сT1N1bM0. The disease was detected during a medical examination of the population and confirmed by ultrasound and cytology results.

An ultrasound examination revealed characteristic features of papillary thyroid cancer with the presence of metastases in the regional lymph nodes on the left and focal changes in both thyroid lobes (TI-RADS 3-5). Fine-needle aspiration biopsy of the thyroid nodules and cervical lymph nodes confirmed the diagnosis of papillary thyroid carcinoma with metastasis to the left cervical lymph node.

Surgical intervention was performed to remove the primary tumor and regional metastases, including total thyroidectomy, central neck lymph node dissection, and a left-sided type III modified radical neck dissection through an incision along the midline cervical fold. The surgical approach provided optimal conditions for performing a radical procedure while enabling reconstruction of the soft tissue structure of the neck, minimizing cosmetic defects and preventing potential complications.

Conclusion: Extensive surgical interventions in aesthetically significant areas performed through standard approaches may sometimes negatively affect long-term cosmetic and functional outcomes. The proposed surgical approach, integrating principles of oncology, plastic and reconstructive surgery, systematizes experience from these disciplines to develop the most effective therapeutic strategies for complex cases, in which improving quality of life is a primary objective.

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