Deep Neck Infection: Atypical Presentation of Papillary Thyroid Cancer

Abstract

Deep neck infection is defined as an infectious process in the potential spaces and fascial plane of the neck which may result in a fatal complication. Prompt drainage and broad-spectrum antibiotics are the mainstays of treatment. Deep neck infection as the initial presentation of primary head and neck cancer is not common. Nevertheless, head and neck squamous cell carcinoma is the most common primary head and neck cancer, which could present with cervical metastasis and subsequently becomes infected. Papillary thyroid cancer has a naturally indolent course, and most patients present with a thyroid nodule. However, deep neck infection could be an uncommon presentation of papillary thyroid cancer which may obscure the diagnosis of underlying malignancy. This case report aims to present a rare presentation of papillary thyroid cancer which needs meticulous evaluation. Moreover, the pathological examination should be performed in all cases of deep neck infection for early detection and management of underlying papillary thyroid cancer.

Anaplastic Thyroid Carcinoma Mimicking Cervical Tuberculosis: A Case Report

“…Even the rare similar cases reported in the literature were thyroid carcinomas mimicking the presentation of cervical abscess rather than tuberculosis [4,5,6]. In fact, Loh TL et al [4] reported a rare case in 2018 of anaplastic thyroid carcinoma mimicking a thyroid abscess in a 52-year-old patient.…”

“…Mahattanapreut et Al. [5] Reported in 2021 a case 67-year-old patient presented with a large abscess involving the retropharyngeal space, oro-hypopharynx, larynx, and left lobe of the thyroid gland with multiple lymphadenopathies with cystic necrosis. The patient underwent incision and drainage of the abscess and necrotic tissue samples were sent for histopathology.…”

“…However, it is very rare for thyroid cancer to present as cervical tuberculosis. To our knowledge, only three cases of thyroid carcinoma initially manifesting as a neck abscess have been reported [4,5,6]. In this report, we describe a very rare case of an adult who presented with symptoms resembling cervical tuberculosis and pathological results ultimately revealed anaplastic thyroid carcinoma.…”