Abstract
Background: Thyroid cancer presenting with cervical lymphadenopathy as a sole occurrence is uncommon. It usually presents as a palpable thyroid mass or nodule. Isolated cervical lymphadenopathy is rare and hence poses a diagnostic challenge. Fine needle aspiration- cytology (FNAC) or biopsy are important modalities which help establish the origin. Case Report: Two cases of lateral cervical lymphadenopathy with no other specific clinical findings were encountered within a span of two weeks with different clinical backgrounds. First to present was a 28 year old young male with a months’ history of lateral cervical swelling. Later a 58 year old male also presented without any history of overt primary thyroid carcinoma. FNAC in both the cases confirmed presence of metastasis from occult primary papillary cancer thyroid. Following this ultrasonography neck was performed which revealed a solid-cystic mass in both the cases. In the younger male an ill-defined solid nodule with microcacifications was identified in the left thyroid lobe while in the case of elderly male; thyroid gland was normal. Subsequently both underwent total thyroidectomy with left neck dissection and histologically proven primary papillary thyroid cancer was found. Conclusion: Posterior cervical lymphadenopathy occurring primarily as a result of papillary carcinoma thyroid is rare. DOI: 10.21276/APALM.1149
Highlights
Thyroid cancer presenting with cervical lymphadenopathy as sole occurrence is uncommon.[1,2,3]
We hereby report two cases of papillary carcinoma thyroid presenting as lateral cervical masses
Possibility of metastatic papillary carcinoma thyroid was suggested on Fine needle aspiration- cytology (FNAC)
Summary
Thyroid cancer presenting with cervical lymphadenopathy as sole occurrence is uncommon.[1,2,3] Cervical lymphadenopathy is attributable to a variety of nonneoplastic and neoplastic causes with likelihood of a benign process in younger patients. We hereby report two cases of papillary carcinoma thyroid presenting as lateral cervical masses. Case 1: A 28-year old male patient presented with brief history of a months’ duration of an enlarging left neck mass. Possibility of metastatic papillary carcinoma thyroid was suggested on FNAC. Following this Ultrasonography of neck was done. Case 2: A 58-year old male presented with a left sided neck mass of three months’ duration. Nontender 3x2cm mass was noted on left side of neck. FNAC was performed that showed syncytial aggregates and papillary fragments without apparent fibrovascular cores. USG on follow up revealed a well-defined solid- cystic mass in left side of neck of size 2cms and both lobes of thyroid showed apparently normal size and echotexture.
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