Abstract
Papillary thyroid carcinoma is well known for its low malignant potential and good prognosis. The outcome can be fatal in patients with low compliance and delayed treatment. Recent advances in ultrasonographic screening and US guided fine needle aspiration biopsy has facilitated early diagnosis of papillary thyroid carcinomas. This epithelial thyroid tumour accounts for more than 80 % of all thyroid tumours. An occult primary carcinoma of thyroid presenting as lymphangioma has been reported rarely. We present a case of a 40-year-old female patient with huge cystic midline swelling on the right side of the neck mimicking lymphangioma on USG. MRI neck showed a cystic mass causing displacement of the trachea and arising from Rt lobe of thyroid gland. Hemithyroidectomy was carried out and histopathology revealed papillary carcinoma. In patients with neck swellings presenting as huge cystic mass the differential diagnosis of Intra cystic variant of papillary carcinoma thyroid and metastatic thyroid papillary carcinoma must always be considered prior to planning surgery.
References
Scott A, Hundahl SA, Fleming ID, Fremgen AM, Menck HR (1998) A national cancer data base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995. Cancer 83(12):2638–22948
Benito HI, Sánchez RA, Rodríguez PM et al (2001) Simple thyroid cyst. Rev Esp Med Nucl 20(1):32–35
Seven H, Gurkan A, Cinar U, Vural C, Turgut S (2004) Incidence of occult thyroid carcinoma metastases in lateral cervical cysts. Am J Otolaryngol 25(1):11–17
Nakagawa T, Takashima T, Tomiyama K (2001) Differential diagnosis of a lateral cervical cyst and solitary cystic lymph node metastasis of occult thyroid papillary carcinoma. J Laryngol Otol 115(3):240–242
Attie JN, Setzin M, Klein I (1993) Thyroid carcinoma presenting as an enlarged cervical lymph node. Am J Surg 166(4):428–430
Loughran CF (1991) Case report: cystic lymph node metastasis from occult thyroid carcinoma: a sonographic mimic of a branchial cleft cyst. Clin Radiol 43(3):213–214
Monchik JM, De Petris G, De Crea C (2001) Occult papillary carcinoma of the thyroid presenting as a cervical cyst. Surgery 129(4):429–432
Andersen PE, Kinsella J, Loree TR, Shaha AR, Shah JP (1995) Differentiated carcinoma of the thyroid with extrathyroidal extension. Am J Surg 170(5):467–470
Frates MC, Benson CB, Charboneau JW et al (2006) Management of thyroid nodules detected at US: society of radiologists in ultrasound consensus conference statement. Ultrasound Q 22(4):231–238
Jun P, Chow LC, Jeffrey RB (2005) The sonographic features of papillary thyroid carcinomas: pictorial essay. Ultrasound Q 21(1):39–45
Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB Jr (2003) Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med 22(10):1083–1090
Hoang JK, Lee WK, Lee M, Johnson D, Farrell S (2007) US features of thyroid malignancy: pearls and pitfalls. Radiographics 27(3):847–860
Al-Brahim N, Asa SL (2006) Papillary thyroid carcinoma: an overview. Arch Pathol Lab Med 130(7):1057–1062
Tae HJ, Lim DJ, Baek KH et al (2007) Diagnostic value of ultrasonography to distinguish between benign and malignant lesions in the management of thyroid nodules. Thyroid 17(5):461–466
Beahrs O, Kiernan P, Hubert JJ (1981) Cancer of the thyroid gland. In: Suen J, Myers E (eds) Cancer of the head and neck. Churchill Livingstone, New York, pp 599–632
Chi HS, Wang LF, Chiang FY, Kuo WR, Lee KW (2007) Branchial cleft cyst as the initial impression of a metastatic thyroid papillary carcinoma: two case reports. Kaohsiung J Med Sci 23(12):634–638
Muller N, Cooperberg PL, Suen KCH, Thorson SC (1985) Needle aspiration biopsy in cystic papillary carcinoma of the thyroid. Am J Roentgenol 144(2):251–253
Cooper DS, Doherty GM, Haugen BR et al (2009) Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11):1167–1214
Conflict of interest
None.
Financial support
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Baser, B., Munjal, V.R. & Roy, M.T. Papillary Carcinoma of Thyroid with an Unusual Presentation. Indian J Otolaryngol Head Neck Surg 67 (Suppl 1), 145–148 (2015). https://doi.org/10.1007/s12070-014-0746-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-014-0746-y