Papillary thyroid carcinoma presenting as a lateral neck cyst

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Solitary lateral cervical cystic masses are rare manifestations of papillary thyroid carcinoma.
• This presentation often lacks palpable thyroid nodules, complicating initial diagnosis.

Purpose of the Study:

• To describe the diagnostic and management experiences with papillary thyroid carcinoma presenting as a lateral neck cyst.
• To highlight the challenges in identifying this uncommon presentation of thyroid cancer.

Main Methods:

• Retrospective review of five patients with papillary thyroid carcinoma presenting as a painless lateral neck cyst.
• Analysis of clinical presentation, diagnostic methods (fine needle aspiration cytology, excisional biopsy), and treatment outcomes.

Main Results:

• No palpable thyroid nodules were detected in any of the five patients.
• Fine needle aspiration cytology confirmed papillary thyroid carcinoma in 60% of cases; excisional biopsy was diagnostic in the remainder.
• All operated patients showed papillary thyroid carcinoma with lymph node involvement; three underwent thyroidectomy and neck dissection.

Conclusions:

• Papillary thyroid carcinoma presenting as a neck cyst represents a diagnostic challenge.
• Excisional biopsy is recommended when fine needle aspiration cytology is inconclusive to exclude malignancy.