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Parapharyngeal Nodal Metastasis in Papillary Thyroid Carcinoma: Catching Early

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Background

Metastasis to parapharyngeal space in papillary carcinoma of the thyroid is rare and often missed in routine clinical and radiological investigations. Although contrast CT /MRI can be done to locate the parapharyngeal lesion, the diagnosis of metastasis mostly deepened upon aspiration cytology, which is a challenge in difficult anatomical locations. Here, we have emphasized the management dilemma of parapharyngeal metastasis in papillary carcinoma of the thyroid.

Case Report

A 30-year-old female presented with multiple right-side neck swelling for two months. Ultrasonography of right thyroid showed TIRAD V and left thyroid showed TIRAD II. Aspiration cytology of the right thyroid showed Bethesda III and aspiration cytology revealed thyroid follicles. Due to the diagnostic ambiguity, contrast-enhanced CT scan was advised. It revealed a hypervascular lymph node in the parapharyngeal space besides multiple right cervical lymph nodes and later changed the treatment plan.

Conclusion

- Metastasis to parapharyngeal space in Papillary carcinoma of the thyroid is rare and often missed on routine evaluation. Contrast-enhanced CT/MRI can be added as a primary investigation in challenging cases of suspicious malignancy of the thyroid.

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Authors and Affiliations

  1. Department of ENT, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India

    Abhijeet Kumar Mishra, Pradeep Pradhan, Swagata Chakraborty & Santosh Kumar Swain

  2. Department of Pathology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India

    Pavithra Ayyanar

Authors
  1. Abhijeet Kumar Mishra
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  2. Pradeep Pradhan
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  3. Swagata Chakraborty
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  4. Santosh Kumar Swain
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  5. Pavithra Ayyanar
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Correspondence to Pradeep Pradhan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Mishra, A.K., Pradhan, P., Chakraborty, S. et al. Parapharyngeal Nodal Metastasis in Papillary Thyroid Carcinoma: Catching Early. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04482-5

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  • DOI: https://doi.org/10.1007/s12070-024-04482-5

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