Objectives: We aimed to determine the incidence of unexpected
pathological findings observed during the histopathological
examination of the neck dissection specimens performed
for primary head and neck squamous cell carcinoma,
and their impacts on the treatment and follow-up plans.
Patients and Methods: We retrospectively reviewed 410
patients (369 males, 41 females; 169 patients unilateral,
241 patients bilateral) with a diagnosis of squamous cell
carcinoma of head and neck, who underwent 651 neck dissections.
Results: Unexpected pathological findings were found in 3.2%
of patients and 2% of neck dissections. These unexpected findings
were tuberculosis in eight patients (2%), metastatic papillary
thyroid carcinoma in three patients (0.7%), Warthins tumor
in one patient and cystic hygroma in one patient. All patients
who had metastatic papillary thyroid carcinoma received
radioactive iodine treatment after thyroidectomy. In control
examinations, none of these cases had problem related to
neither primary disease nor thyroid pathology. Only two of eight
patients who had tuberculosis in lymph nodes received medical
treatment for tuberculosis, while the others were observed by
clinical and radiological examinations. None of these patients
had problems related to tuberculosis. We had no long-term
follow-up results for cystic hygroma and Warthins tumor since
these patients did not continue their routine examinations.
Conclusion: During the pathologic examination of neck
dissections, unexpected pathologic findings may occasionally
be encountered. Most frequently seen unexpected
findings were tuberculosis lymphadenitis and metastatic
papillary thyroid carcinoma. However, these pathologic
findings do not seem to affect the management of the
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