Occult papillary thyroid microcarcinoma manifesting only as a symptomatic lateral cervical mass: report of a case

Batori, M; Zullino, Antonio; Pipino, Raoul; Eleni, Chatelou

doi:10.1007/s00595-012-0186-9

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…Batori et al reported a case of a patient who had presented with a cervical mass for 15 months, but had already suffered from dysphagia and dysphonia despite a mere diameter of 5 cm. [3] Therefore, it appears that size and duration of the mass alone do not essentially correspond to its debilitating potential.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2] However, mere microscopic evaluation of fine-needle aspirates might not be sufficient for adequate diagnosis since they are commonly false negative. [3] Instead, thyroglobulin measurements in the specimen have been proven helpful for accurate diagnosis of cystic lesions as thyroid metastases. [2]…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of metastatic disease at the time of diagnosis approaches 50% according to current literature. [3] Affected lymph nodes may undergo nearly complete cystic degeneration which impedes the differentiation between benign cervical cysts and malignant metastatic disease. [6] A cervical neck mass presenting as initial sign of metastatic papillary thyroid carcinoma, as described for the patient presented in this case, is considered extremely rare, though.…”

Section: Introductionmentioning

confidence: 99%

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Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck

Schwaiger

Koeninger²,

Wimbauer³

et al. 2019

Medicine

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Rationale: Papillary thyroid cancer accounts for up to 85% of all cases of thyroid carcinoma. This disease entity is notorious for metastatic invasion of adjacent lymph nodes, including the cervical lymph nodes, potentially presenting as a growing lateral neck mass. However, these lesions tend to be recognized and diagnosed soon due to the palpable mass. Patient concerns: This report describes a very rare case of a huge slow-growing neck metastasis based on a 6 mm papillary thyroid microcarcinoma. This patient presented with a painless, but continuously growing right lateral neck mass. Aside from that, no specific complaints were mentioned. Diagnosis: The underlying cause of this patient's neck mass turned out to be an occult papillary thyroid microcarcinoma (Ø 6 mm) with metastatic invasion and subsequent cystic degeneration of cervical lymph nodes. Accurate diagnosis was made after surgical intervention through histopathological analysis. Interventions: The patient underwent complete resection of the cervical mass in conjunction with total thyroidectomy and right cervical neck dissection, followed by adjuvant iodine- and chemotherapy. Outcome: Margin free surgical resection without any postoperative complications could be achieved. The patient received iodine supplementation and remained free of recurrence during regular clinical follow-ups for 2 years. The therapy was curative. Lessons: This case report emphasizes the importance of a thorough diagnostic work-up including preoperative tissue sampling of any cervical neck mass, since a benign appearance on imaging does not exclude a malignant process.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck

Schwaiger

Koeninger²,

Wimbauer³

et al. 2019

Medicine

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“…PTC is characterized by slow growth and indolent biological behavior, but with frequent cervical lymph node metastases. By the time of diagnosis PTC has already spread to cervical lymph nodes in 20% -50% of patients [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Thyroid Papillary Carcinoma in a Branchial Cleft Cyst—A Case Report

Papadakis¹,

Ladias²,

Chimona³

et al. 2017

JCT

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Objective: Report a rare case of a thyroid papillary carcinoma situated within a branchial cleft cyst. Case presentation: A 40-year-old male was referred to our department for a lateral neck mass assessment. Physical examination revealed a solitary palpable, painless, moveable neck mass. Assessment included complete nasal, pharynx and larynx endoscopy, neck computed tomography, and fine needle aspiration biopsy. Treatment was surgical excision of the neck mass. Histopathology confirmed a branchial cleft cyst with papillary thyroid carcinoma growth at a site. A neck and thyroid ultrasound showed presence of thyroid gland nodules (one of which with micro calcifications). Thyroid fine needle aspiration biopsy performed, was high suspicious for malignancy (BETHESDA V). Patient underwent total thyroidectomy and histopathology revealed papillary thyroid carcinoma. Conclusion: Although rarely, it is possible to face an unexpected malignancy within a clinically benign neck lesion. A thorough diagnostic work-up enables early identification of aforementioned potential malignancy. A diagnostic dilemma that arises in such cases is between primary or metastatic disease and a thyroid carcinoma arising from ectopic thyroid tissue.

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Multiple simple cystic metastases in the lateral neck at presentation with papillary thyroid microcarcinoma

Zhu

Zhou

et al. 2021

Medicine

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Introduction: Metastasis of a papillary thyroid microcarcinoma (PTMC) in the lateral neck is characterized primarily by solid lymphadenopathy, although some cases may rarely present with a cervical cystic mass. We report a case of lateral cervical lymph node metastases of PTMC that appeared as a cystic lymphangioma of the lateral neck. Patient concerns: A 55-year-old man with a painless egg-sized mass in the right side of the neck that had been present for 1 month underwent physical examination, ultrasonography, computed tomography (CT), fine needle aspiration biopsy (FNAB), and intraoperative fast-frozen pathological examination, which indicated that the cystic masses in the neck were benign. However, the final pathology report identified the lateral neck masses as lymph node metastases of thyroid carcinoma. Diagnosis: The patient was diagnosed with PTMC of the right lobe of the thyroid gland with lateral neck metastases. Interventions: The patient underwent right cervical neck dissection together with a right thyroidectomy, followed by levothyroxine therapy and routine follow-up. Outcomes: No postoperative complications were reported, and the thyroid-stimulating hormone inhibition target was <0.1 mmol/L; there was no detectable tumor recurrence on routine clinical follow-up for up to 16 months. Conclusions: This case report emphasizes the need to consider cervical lymph node metastases of thyroid carcinoma in the differential diagnosis for patients with large, multiple, simple cystic neck masses.

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Occult papillary thyroid microcarcinoma manifesting only as a symptomatic lateral cervical mass: report of a case

Cited by 5 publications

References 13 publications

Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck

Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck

Thyroid Papillary Carcinoma in a Branchial Cleft Cyst—A Case Report

Multiple simple cystic metastases in the lateral neck at presentation with papillary thyroid microcarcinoma

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