Papillary thyroid carcinoma with metastatic cervical lymphadenopathy

Case contributed by Dr Bahman Rasuli

Presentation

Palpable cervical masses more obviously on the left side.

Patient Data

Age: 85 years
Gender: Female

The whole thyroid gland has an altered signal in keeping with diffuse infiltrative tumoral involvement and contiguous with soft tissue extending into the left strap muscles and subcutaneous region

Thyroid and cricoid cartilages show abnormal signal intensity and enhancement

Numerous abnormal signals enhancing lymphadenopathy of different sizes at almost neck zones more dominantly on the left side forming a conglomerated shape causing swelling of the neck and displacement of neck internal structures

Some of the lymph nodes show internal cystic changes

Bulging of the right posterior pharyngeal wall by the internal carotid artery

Reversed cervical lordosis

Multilevel disco-osteophyte bulging with thecal sac indentation.

Case Discussion

The recent patient already has a pathologically proven case of papillary thyroid carcinoma 9 months ago and left untreated.

Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland and frequently has nodal metastases at presentation. The presence of lymph node metastasis in the neck has a more frequent recurrence rate but no higher mortality rate. PTCs that invade the adjacent tissues next to the thyroid gland have a worse prognosis due to a high local recurrence rate.

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