Occult Metastatic Papillary Thyroid Cancer in an Adolescent

Q3 Medicine AACE Clinical Case Reports Pub Date : 2024-01-01 DOI:10.1016/j.aace.2023.11.005

Anna Chin MD, MPH , Renee Robilliard DO , Jan C. Groblewski MD , John M. Tarro MD , Sonja Chen MD , Lisa Swartz Topor MD, MMSc

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Abstract

Background/Objective

Occult papillary thyroid carcinoma (PTC) is PTC with metastasis but without identification of primary thyroid cancer on preoperative ultrasonography. Published reports on occult PTC in children are limited.

Case Report

We describe a 16-year-old female with occult PTC who initially presented with a painless left sided cystic neck mass. Diffuse sclerosing variant papillary thyroid cancer was found in the resected neck mass and thyroid ultrasound did not show any nodules or features of carcinoma. After total thyroidectomy, pathological examination of the thyroid revealed papillary thyroid microcarcinoma.

Discussion

We describe a rare case of occult diffuse sclerosing variant papillary thyroid cancer presenting as a cystic neck mass mimicking a second branchial cleft cyst in an adolescent patient. When metastatic PTC is found without evidence of nodule on thyroid imaging, occult PTC of the thyroid is the likely diagnosis.

Conclusion

Total thyroidectomy ± neck dissection followed by TSH suppression and radioactive iodine therapy remains the appropriate diagnostic and therapeutic interventions.

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一名青少年的隐匿转移性甲状腺乳头状癌

背景/目的隐匿性甲状腺乳头状癌（PTC）是指有转移但术前超声检查未发现原发性甲状腺癌的PTC。病例报告我们描述了一名患有隐匿性甲状腺乳头状癌的 16 岁女性患者，她最初表现为左侧颈部无痛性囊性肿块。在切除的颈部肿块中发现了弥漫性硬化变异型甲状腺乳头状癌，甲状腺超声检查未发现任何结节或癌的特征。讨论我们描述了一例罕见的隐匿性弥漫性硬化变异型甲状腺乳头状癌病例，该病例在青少年患者中表现为模仿第二个腮裂囊肿的颈部囊性肿块。当甲状腺影像学检查未发现结节证据而发现转移性PTC时，甲状腺隐匿性PTC是可能的诊断依据。结论甲状腺全切除术±颈部切除术后，TSH抑制和放射性碘治疗仍是适当的诊断和治疗干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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