Papillary thyroid microcarcinoma with a large cystic dilated lymph node metastasis to the neck: mimicing a branchial clef cyst

Özdemar O. İ. , Özbilen G., Kafkaslı Ç., KALCIOĞLU M. T. , Zenginkinet T., Tamer H. G.

9th Balkan Congress of Otorhinolaryngology, 01 June 2014, pp.15

  • Publication Type: Conference Paper / Full Text
  • Page Numbers: pp.15


Objectives; Papillary thyroid carcinoma is the most common and well-differentiated
malignant tumor of the thyroid gland. Tumor size that is smaller than 10 mm is named
as thyroid papillary microcarcinoma. Cervical cystic neck mass in a young adult,
which is located classically anterior to the sternocleidomastoid muscle, is most
commonly branchial cleft cyst if otherwise proven not. Lateral cervical cystic mass in
a young adult very rarely could be a first sign of an occult thyroid papillary
microcarcinoma metastasis.
Case Report; In this paper, we presented a 37 year-old male patient whose
preoperative 6 cm left lateral cervical cystic mass was prediagnosed as branchial cleft
cyst, but then the postoperative histopathological examination of the mass revealed as
papillary thyroid carcinoma metastasis. Preoperative fine needle aspiration biopsy
was relevant with a branchial cleft cyst. Ultrasonographic evaluation of the thyroid
gland showed that in the left lobe of thyroid gland had 3 solid nodules with 4, 6 and
15 mm dimensions, respectively, but no nodule found in the right lobe, and also in the
isthmus of the thyroid gland. Fine needle aspiration biopsies were performed to
suspected nodules, but no malignant cell was detected except one 6 mm nodule,
which was suspected having malignant well differentiated cells. Total thyroidectomy
was performed to the patient, and postoperative histopathologic examination of
biopsy material’s result showed that two papillary thyroid microcarcinomas with
dimentions of 4 and 6 mm, respectively.
Conclusion; In a young adult with lateral cervical cystic mass should be carefully
considered preoperatively for the possibility of metastatic occult thyroid carcinoma,
especially for papillary carcinoma in differential diagnosis, and evaluation of the
thyroid gland should be taken into account.