Occult Metastatic Papillary Thyroid Cancer in an Adolescent

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

AACE Clinical Case Reports (Jan 2024)

Occult Metastatic Papillary Thyroid Cancer in an Adolescent

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

Affiliations

Anna Chin, MD, MPH: Division of Pediatric Endocrinology and Diabetes, Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island
Renee Robilliard, DO: Division of Pediatric Endocrinology and Diabetes, Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island; Address correspondence to Dr Renee Robilliard, Pediatric Endocrinology and Diabetes Center, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903.
Jan C. Groblewski, MD: Division of Otolaryngology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
John M. Tarro, MD: Rhode Island ENT Physicians, Inc, Providence, Rhode Island
Sonja Chen, MD: Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, Ohio; Department of Pathology, The Ohio State University College of Medicine, Columbus, Ohio
Lisa Swartz Topor, MD, MMSc: Division of Pediatric Endocrinology and Diabetes, Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island

Journal volume & issue: Vol. 10, no. 1
pp. 27 – 30

Abstract

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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.

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

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