Jugulodigastric papillary thyroid cancer lymph node metastasis masquerading as carotid body tumor

Document Type : Case Report


1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Thyroid nodule is the most common presentation of thyroid carcinoma. Considering the indolent course of the disease, indeed, the papillary thyroid cancer (PTC) microcarcinoma puts much debate regarding large-scale cohorts on patient follow-up over several decades to detect differences in aggressiveness and outcome [1]. Lymph node metastases might be the salient manifestation of the disease. The nodal metastases usually appear in the central and to a lesser degree in the lateral neck mostly as a solid nodule and rarely in form of a cystic mass. In this study, we describe a case of lymph node metastasis from thyroid papillary carcinoma that clinically and radiologically mimicked a carotid body tumor and despite all pre-surgical evaluations; papillary thyroid carcinoma was detected in the final histopathology report. We intend to describe the initial clinical evaluation, radiological survey and pathology report.


Main Subjects

  1. Cappelli C, Castellano M, Braga M, Gandossi E, Pirola I, De Martino E, Agosti B, Rosei EA. Aggressiveness and outcome of papillary thyroid carcinoma (PTC) versus microcarcinoma (PMC): a mono-institutional experience. J Surg Oncol. 2007 Jun 1;95(7):555-60.
  2. Aygun N, Uludag M. Pheochromocytoma and Paraganglioma: From Epidemiology to Clinical Findings. Sisli Etfal Hastan Tip Bul. 2020 Jun 3;54(2):159-168.
  3. Griauzde J, Srinivasan A. Imaging of vascular lesions of the head and neck. Radiol Clin North Am. 2015 Jan;53(1):197-213.
  4. Yafit D, Horowitz G, Vital I, Locketz G, Fliss DM. An algorithm for treating extracranial head and neck schwannomas. Eur Arch Otorhinolaryngol. 2015 Aug;272(8):2035-8.
  5. Som PM, Curtin HD. Lesions of the parapharyngeal space. Role of MR imaging. Otolaryngol Clin North Am. 1995 Jun;28(3):515-42.
  6. Arya S, Rao V, Juvekar S, Dcruz AK. Carotid body tumors: objective criteria to predict the Shamblin group on MR imaging. AJNR Am J Neuroradiol. 2008 Aug;29(7):1349-54.
  7. Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer of the endocrine system. In:  Niederhuber JE, Armitage JO, Kastan MB, Doroshow  JH, Tepper  JE, editors. Abeloff's clinical oncology. 6th ed. Elsevier; 2020. p. 1074-107.
  8. Fu H, Sa R, Cheng L, Jin Y, Qiu X, Liu M, Chen L. Updated Review of Nuclear Molecular Imaging of Thyroid Cancers. Endocr Pract. 2021 May;27(5):494-502.
  9. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014 Jan-Feb;64(1):9-29.
  10. White ML, Gauger PG, Doherty GM. Central lymph node dissection in differentiated thyroid cancer. World J Surg. 2007 May;31(5):895-904.
  11. Yeh MW, Bauer AJ, Bernet VA, Ferris RL, Loevner LA, Mandel SJ, Orloff LA, Randolph GW, Steward DL; American Thyroid Association Surgical Affairs Committee Writing Task Force. American Thyroid Association statement on preoperative imaging for thyroid cancer surgery. Thyroid. 2015 Jan;25(1):3-14.