Occult papillary carcinoma of thyroid presenting as cervical lymphadenopathy in a young male: case report

Nida Khan, Abhishek Mahadik, Meena Kumar, Manish Kumar


Papillary carcinoma of thyroid accounts for 80% of all thyroid malignancies. They tend to have a female preponderance and present in the 4th to 5th decade of life, as a slow growing midline mass. Cervical metastases are common, blood borne being rare. We present a case of a 29 years old who presented with cervical lymphadenopathy that was secondary to an occult papillary carcinoma of thyroid. Patient underwent total thyroidectomy with bilateral neck node dissection for the same.


Papillary carcinoma thyroid, Occult primary, Orphan Annie eye nuclei

Full Text:



Schwartz’s Principles of Surgery, 10th edition, pg. 1542.

Monchik, Jack M, Petris GD, Crea CD. Occult papillary carcinoma of the thyroid presenting as a cervical cyst. Surg. 2001;129(4):429-32.

Strate, Susan M, Lee EL, Childers JH. Occult papillary carcinoma of the thyroid with distant metastases. Cancer. 1984;54(6):1093-100.

Kilfoy AB, Ward MH, Sabra MM, Devesa SS. Thyroid cancer incidence patterns in the United States by histologic type, 1992-2006. Thyroid. 2011;21(2):125-34.

Albi E, Cataldi S, Lazzarini A. Radiation and Thyroid Cancer. Int J Mol Sci. 2017;18(5):911.

Gullo I, Batista R, Pereira PR, Soares P, Barroca H, Sucesso MDB, et al. Multinodular Goiter Progression Toward Malignancy in a Case of DICER1 Syndrome: Histologic and Molecular Alterations. Am J Clin Pathology. 2018;149(5):379-86.

Rosai J, Carcangui ML, Lellis DRA. Tumors of the Thyroid Gland. Atlas of Tumor Pathology, Fascicle 5. Armed Forces Institute of Pathology: Washington, DC; 1992.

Carcangui ML, Zampi G, Pupi A. Papillary carcinoma of the thyroid: a clinico-pathologic study of 241 cases treated at the University of Florence, Italy. Cancer. 1985;55:805-28.

Hoie J, Stenwig AE, Kullmann G. Distant metastases in papillary thyroid cancer. A review of 91 patients. Cancer. 1988;61:1-6.

Noguchi, Shiro, Noguchi A, Murakami N. Papillary carcinoma of the thyroid I. Developing pattern of metastasis. Cancer. 1970;26(5):1053-60.

Carcangiu, Luisa M. Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy. Cancer. 1985;55(4):805-28.

Rotstein, Lorne. The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncology. 2009;99(4):186-8.

Kebebew, Electron, Clark OH. Differentiated thyroid cancer: complete rational approach. World J Surg. 2000;24(8):942-51.