A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst with neck node metastasis.

Department of Surgery, Erne Hospital, Enniskillen, County Fermanagh, Northern Ireland.
Ear, nose, & throat journal (Impact Factor: 0.88). 11/2006; 85(10):675-6.
Source: PubMed

ABSTRACT We describe the interesting case of a young man who presented with a lateral neck node that was diagnosed as a branchial cyst. Histopathology of the excised node revealed that a papillary carcinoma was located within thyroid tissue, which in turn was located within a branchial cyst. A total thyroidectomy with local lymph node clearance was performed. Histology identified a normal thyroid gland, but a papillary carcinoma in one of the excised lymph nodes was consistent with a metastasis. To our knowledge, this is only the second reported case of a thyroid carcinoma arising in ectopic thyroid tissue that metastasized in the neck.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We report a rare case of papillary thyroid carcinoma incidentally found within a branchial cleft cyst. Only four other cases have been described in the literature. A total thyroidectomy and selective neck dissection was performed, and no evidence of occult primary disease was found after review of fine sections. Branchial cleft cysts are the most common lateral neck masses. Ectopic thyroid tissue within a branchial cleft cyst is an unusual phenomenon, and papillary thyroid carcinoma arising from this tissue is extremely rare. Clinicians are left with a diagnostic dilemma when presented with thyroid tissue neoplasm within a neck cyst in the absence of a thyroid primary-is this a case of metastatic disease with a missed primary or rather carcinoma arising in ectopic thyroid tissue? A thorough discussion of the etiologies of these lateral neck masses is reviewed including the embryogenesis of thyroid tissue in a branchial cleft cyst. The prognosis of patients with papillary thyroid carcinoma in lateral neck cysts without a primary site identified appears to be good following excision of the cyst and total thyroidectomy. Other management recommendations regarding these unique lateral neck malignancies are also presented.
    07/2013; 2013:405342. DOI:10.1155/2013/405342
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Thyroid papillary carcinoma arising from a branchial cleft cyst is extremely uncommon and the diagnosis should strictly meet Sidhu's criteria. Only eight cases have been reported so far. Immunohistochemical studies, including TTF-1, P63, and thyroglobulin play a crucial role in differential diagnosis. We present a large metastatic cystic cervical lymph node showing patterns of thyroid papillary carcinoma mimic papillary thyroid carcinoma originating from a branchial cleft cyst both clinically and histologically.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Solitary lateral cervical cystic mass is an uncommon presentation of papillary thyroid carcinoma. To report our recent experience in the diagnosis and management of papillary thyroid carcinoma presenting as a lateral neck cyst. Patients who had papillary thyroid carcinoma and presented as a painless lateral neck cyst at the Department of Surgery, Al-Ain Hospital, from April 2005 to June 2009 were retrospectively studied. Their clinical presentation, diagnosis and management were reviewed. Five patients were studied. No thyroid nodules were clinically palpable in all patients. Fine needle aspiration cytology from the cyst was positive for papillary thyroid carcinoma in three patients (60 percent). Two patients were diagnosed after excisional biopsy. Three patients had total thyroidectomy with modified radical neck dissection and postoperative radioactive iodine ablation. Two patients preferred to travel overseas for treatment. Thyroid histopathological examination has shown papillary thyroid carcinoma in all operated patients with multiple microscopic foci in two of them. This was associated with multiple bilateral cervical lymph node involvement. Metastatic papillary thyroid carcinoma presenting as a neck cyst is a diagnostic challenge. Excisional biopsy is indicated if fine needle aspiration cytology was inconclusive so as to rule out malignancy.
    African health sciences 06/2011; 11(2):296-300. DOI:10.4314/ahs.v11i2.68462 · 0.66 Impact Factor