Table 4.

Algorithm for management

Incidental pathological finding of thyroid tissue in cervical lymph nodes
↓		↓
Papillary (PTC)		Follicular
↓		↓	↓
Imaging of thyroid		Corresponding with criteria of Table 3	Not corresponding with criteria of Table 3
↓	↓	↓	↓
“Negative”	“Positive”	Inclusions	Suspicious of metastasis
↓	↓	↓	↓
“Wait and watch”, but see text for option of further surgery	Further thyroid surgery depending on age, co-morbidities, control of primary upper aero-digestive cancer, and patient preferences	No further action, but imaging of thyroid is optional and clinical correlation is advisable	Imaging of thyroid
			↓	↓
			“Negative”	“Positive”
			↓	↓
			“Wait and watch”, but see text for option of further surgery	Further thyroid surgery depending on age, co-morbidities, control of primary upper aero-digestive cancer, and patient preferences