Lateral neck mass. Sole presenting sign of metastatic thyroid cancer

Two hundred sixty-eight cases of thyroid cancer treated at the University of Michigan, Ann Arbor, from 1974 to 1984 were evaluated. Thirty-six patients had, as the sole presenting sign, a lateral neck mass that proved to be metastatic thyroid cancer. In every instance, the thyroid gland was clinically normal on initial evaluation. Thyroid scans were found to be of little value in the preoperative evaluation of the lateral neck mass. Surgical treatment consisted of total thyroidectomy and modified or radical neck dissection. Foci of thyroid cancer were found on pathologic evaluation of all thyroid glands removed, supporting the concept of metastatic cancer rather than the lateral aberrant thyroid associated with developmental cell rests.