Turkish Archives of Otorhinolaryngology (Dec 2004)

Papillary thyroid carcinoma causing cystic cervical metastasis and metachronic laryngeal cancer

  • Bülent Aktan,
  • Harun Üçüncü,
  • Yavuz Sütbeyaz,
  • Ümran Yıldırım,
  • Mecit Kantarcı

Journal volume & issue
Vol. 42, no. 4
pp. 236 – 240

Abstract

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Although cystic masses in the neck are usually benign, they rarely appear to be malign lesions. Malign cystic masses may be both primary and secondary. The primary ones are branciogenic carcinomas that develop from branchial cyst while the secondary ones are metastatic tumours. Cystic metastases in the neck often appear as a result of the metastasis of squamous cell carcinoma in lingual or palatine tonsil to the lymph nodes. However, the papillary thyroid carcinoma and squamous cell carcinoma of the larynx, though rarely, may lead to cystic metastasis in the neck. This article presents the case of a 65-year-old male patient who applied to our clinic with the complaint of hoarseness and who was diagnosed with metachronic laryngeal cancer and papillary thyroid carcinoma that causes metastasis to the neck. The result of the patient’s laryngeal biopsy was indicated as squamous cell carcinoma. The cytological results of the fine needle aspiration biopsies taken from the thyroid node and the mass on the right cervical area was the papillary carcinoma. The MRI analysis of the mass in the neck revealed that lesion contained cystic necrotic areas and contrasting. The patient was applied total thyroidectomy, total laryngectomy and bilateral Type III modified radical neck dissection. The analysis of the neck mass resulted in the papillary thyroid carcinoma metastasis. It is proposed that the presence of the parts that hold contrast in the metastatic cyst in CT might as well be a specific finding of papillary thyroid carcinoma. It must always be kept in mind that head and neck malignancies may cause cystic metastasis to the cervical area, that the observation of the parts that hold contrast in the cyst in CT or MRI should always be taken as a warning for malignancy in the diagnosis of the cystic masses in the neck, and that there is always a probability of multiple primary malignancy.

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