Thyroid Papillary Microcarcinoma Revealed by Cystic Lymph Node Metastasis

Case Report

Annals Thyroid Res. 2017; 3(2): 120-121.

Thyroid Papillary Microcarcinoma Revealed by Cystic Lymph Node Metastasis

Tatari MM*, Anajar S, Halily S, Abada R, Rouadi S, Roubal M and Mahtar M

ENT Department, University Hospital Centre IBN ROCHD, Morocco

*Corresponding author: Mohamed MoutaaTatari, ENT Department, Face and Neck Surgery, Hospital August, 20’1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco

Received: October 12, 2017; Accepted: October 23, 2017; Published: November 01, 2017

Abstract

Introduction: Thyroid papillary microcarcinomas revealed by cystic cervical lymph node metastasis are exceptionally observed. Cervical cystic masses are most often associated with bronchial cleft cysts.

Case Report: In this paper, we presented a 63 years old patient presenting an isolated lateral cervical cystic mass for which he was operated. Pathological examination of the surgical specimen found a lymph node metastasis of papillary carcinoma. The thyroidectomy performed afterwards found a papillary microcarcinoma that had gone unnoticed in the initial radiological examinations.

Discussion and Conclusion: Latero-cervical cysts are usually benign, especially in young subjects. But the possibility of a metastatic lesion, in particular of a thyroid carcinoma, must be raised before such situations,hence the value of a good diagnostic strategy.

Keywords: Thyroid Cancer; Papillary microcarcinoma; Lateral cervical cystic mass

Introduction

Thyroid microcarcinomas are defined according to the classification of the World Health Organization (WHO) as carcinomas of size less than or equal to 10mm [1]. Because of their small size, these microcarcinomas escape cervical clinical examination and may not even be detected by imaging. Thyroid carcinomas are dominated by papillary carcinomas, which usually give metastases to the cervical lymph node. These ganglion metastases are usually solid and rarely cystic [2]. Thus, these cystic adenopathies are often interpreted as benign cystic masses [3], especially if the thyroid appears normal. The aim of this work is to report a case of papillary microcacinoma of the thyroid revealed by a cystic ganglionic metastasis initially taken for a benign primitive cervical cystic mass, and to highlight the paraclinical features that may make these lesions suspect.

Clinical Case

A 63-year-old male patient with no history of cervical irradiation or familial thyreopathy, who has had two years of progressively enlarged, and painless cervical mass with no signs of compression. The clinical examination found a right lateral cervical mass, resembling 5x3cm, movable, without inflammatory signs (Figure 1).