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Abstract
INTRODUCTION:
Papillary thyroid carcinoma (PTC) is the most common and well-differentiated type of thyroid cancer, with tumors ≤10 mm classified as papillary thyroid microcarcinoma (PTMC) by the World Health Organization. This case highlights a BCC initially diagnosed as benign but later found to harbor metastatic PTC. It emphasizes the need for careful evaluation of atypical neck masses to avoid delayed diagnosis and treatment.
CASE PRESENTATION
This case involves a 35-year-old woman with a three-year history of right-sided neck swelling and breathing difficulty, initially presumed to have a branchial cleft cyst (BCC) based on clinical findings and FNAC. Surgical removal of the cystic mass confirmed a type 2 BCC. However, continued symptoms led to further imaging and thyroid evaluation, which revealed a small nodule. Histopathology confirmed a unifocal papillary thyroid microcarcinoma (PTMC) in the right lobe. The case underscores the importance of considering hidden malignancy in seemingly benign lateral neck masses.
DISCUSSION
Although PTMC typically follows an indolent course, cystic lymph node metastases may signal aggressive behavior. Misdiagnosis as benign neck cysts can delay appropriate treatment. This case emphasizes the need for thorough evaluation of adult-onset lateral neck masses and supports early surgical intervention for accurate diagnosis and optimal management.
KEYWORDS :
Papillary Thyroid Microcarcinoma (C563277 ) , Metastasis ( D009362 ) , Branchial Cleft Cyst (D001935 ), Thyroidectomy (D013965)