ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P131

A long standing lymph node metastasis from occult thyroid papillary carcinoma: 10 years evolution until positive diagnosis

Cristina Preda1, Roxana Stanciu1, Alexandru Grigorovici1, Victor Costan1, Carmen Vulpoi1, Doina Piciu2 & Eusebie Zbranca1


1University of Medicine and Pharmacy ‘Gr.T.Popa’, Iasi, Romania; 2Institute of Oncology ‘I.Chiricuta’, Cluj, Romania.


Papillary thyroid carcinoma is a slow growing tumor and is reputed to have an excellent prognosis. In 10–20% of cases, the presence of lymph node metastases led to diagnosis.

Objective: To present a patient with enlarged lateral cervical masses, present for 10 years, that proved to be lymph nodes with metastatic thyroid papillary carcinoma.

Case report: We report a case of an 26-year-old female patient with 10 years evolution of enlarged cervical masses in the absence of readily palpable thyroid nodularity. Thyroid ultrasonography disclosed tow solid nodules <0.5 ml in the left lobe. Thyroid function was normal and technetium Tc 99 m pertechnetate scan revealed no ‘cold’ nodules. A lymph node biopsy was required and the lesions were histologically metastasis of papillary carcinoma. The patient underwent total thyroidectomy with lymph node neck dissection and superior mediastinal lymph node dissection followed by radioactive iodine therapy. After 4 months, the wholebody scan was negative and the tyroglobuline decreased from 701 to 21.97 ng/ml.

Conclusions: In a young patient with lateral cervical masses, the diagnosis of lymph node metastasis from occult papillary carcinoma should be considered. Even the diagnosis was made after 10 years of slow evolution, the right treatment (surgery and radioiodine therapy) succeeded.

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