Metastatic Papillary Thyroid Cancer with no Primary Tumor in the Thyroid Gland

Abstract

Papillary-type thyroid cancers are common malignancies in the head and neck region. They mostly appear without any metastasis because most cases are discovered incidentally. According to recent guidelines, papillary microcarcinoma can be safely followed over ten years, and only a small percentage will show significant growth or metastasis. Approximately one third of adults have papillary microcarcinomas in their thyroid, but most will never progress into metastatic cancer. Here, we describe a male adult treated for cervical metastasis of papillary cancer in the thyroid gland. The patient underwent total thyroidectomy, central neck dissection, and lateral neck dissection. A meticulous histological examination showed papillary thyroid cancer metastasis in the central compartment as well as in region 4 in the lateral compartment. There was no sign of primary papillary cancer in the thyroid gland. Only a few cases have been found in the literature when cervical metastasis of papillary cancer appears without any detectable primary focus in the thyroid gland.