This isolated PTC recurrence in the deep SH-SCM plane, detected about eight years after TOETVA, is highly suggestive of delayed tract-related implantation with a latency of at least five years, although causality cannot be proved. The case emphasizes strict adherence to recommended dissection planes, careful handling of lymph-node specimens, and consideration of extended, access-tract-oriented ultrasound surveillance in young patients undergoing TOETVA.
Wang et al. (Wed,) studied this question.