A 52-year-old woman with a 3 cm classical papillary thyroid carcinoma and clinically positive central compartment lymph nodes (cN1a) undergoes total thyroidectomy. What is the recommended extent of neck dissection?

• A Prophylactic central compartment dissection only
• B Modified radical neck dissection including levels II to V
• C Therapeutic central compartment (level VI) neck dissection ✓
• D Lateral compartment dissection only with preservation of central nodes

Explanation

Clinically positive central compartment nodes require therapeutic central compartment (level VI) neck dissection, removing all lymphatic tissue from the hyoid bone to the innominate artery and between the carotid sheaths. Prophylactic dissection is inappropriate when nodes are already involved. Lateral neck dissection is indicated only when lateral compartment nodes are involved.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.