Challenges in managing the isolated cervical lymphadenopathy in absence of thyroid nodule

Authors

  • Nikhil Talwar Department of Surgery, Lady Hardinge Medical College and Dr. R. M. L. Hospital, New Delhi, India
  • Gautam anand Department of Surgery, Lady Hardinge Medical College and Dr. R. M. L. Hospital, New Delhi, India
  • Kayenaat Puran Singh Jassi Department of Surgery, Lady Hardinge Medical College and Dr. R. M. L. Hospital, New Delhi, India
  • Rahul Dhamija Department of Surgery, Lady Hardinge Medical College and Dr. R. M. L. Hospital, New Delhi, India
  • Sumit Bhaskar Department of Surgery, Lady Hardinge Medical College and Dr. R. M. L. Hospital, New Delhi, India
  • Akshay Kumar Department of Surgery, Lady Hardinge Medical College and Dr. R. M. L. Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20220960

Keywords:

Papillary carcinoma thyroid, Lateral neck swelling, Isolated cervical lymphadenopathy, Lateral aberrant thyroid, Papillary microcarcinoma

Abstract

Differentiated thyroid cancer make up the vast majority of thyroid cancers with papillary thyroid cancer representing 84% of all thyroid cancer diagnoses. Papillary carcinoma of the thyroid presenting primarily as lateral neck swelling is rare. In the absence of thyroid swelling further evaluation should be done to exclude the primary tumors of scalp and head and neck region. Diagnosis of this condition is made by ultrasound guided FNAC. Surgery is the main treatment modality of choice. Here, we reported a case of an adult female who presented with isolated cervical lymphadenopathy and FNAC revealed metastatic papillary carcinoma of thyroid. Total thyroidectomy with central and posterolateral cervical neck dissection was done, with histology confirming as papillary thyroid carcinoma with local lymphnode metastasis.

References

Schlumberger M, Leboulleux S. Current practice in patients with differentiated thyroid cancer. Nat Rev Endocrinol. 2021;17(3):176-88.

Singh A, Butuc R, Lopez R. Metastatic papillary thyroid carcinoma with absence of tumor focus in thyroid gland. Am J Case Rep. 2013;14:73-5.

Tastekin E, Can N, Ayturk S, Celik M, Ustun F, Guldiken S, et al. clinically undetectable occult thyroid papillary carcinoma presenting with cervical lymph node metastasis. Acta Endocrinol (Buchar). 2016;12(1):72-6.

Shin JH. Ultrasonographic imaging of papillary thyroid carcinoma variants. Ultrasonography. 2017;36(2):103-10.

Ranganath R, Dhillon VK, Shaear M, Rooper L, Russell JO, Tufano RP. Unusual locations for differentiated thyroid cancer nodal metastasis. World J Otorhinolaryngol Head Neck Surg. 2020;6(3):176-81.

Liu J, Liu Y, Lin Y, Liang J. Radioactive Iodine-Refractory Differentiated Thyroid Cancer and Redifferentiation Therapy. Endocrinol Metab (Seoul). 2019;34(3):215-5.

Mitchell AL, Gandhi A, Scott-Coombes D, Perros P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(2):150-60.

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Published

2022-03-28

Issue

Section

Case Reports