RIAVLN metastasis is relatively common in recurrent thyroid carcinoma and represents an anatomically unique nodal group not covered by traditional classifications. In most cases, complete clearance can be safely achieved through a transcervical approach. Partial sternotomy should be reserved for patients with dense adhesions or high bleeding risk. Recognition of this region as a potential site of recurrence and mastery of its surgical anatomy are crucial for achieving optimal oncologic outcomes in thyroid cancer surgery.
Wang et al. (2026) studied this question.