Muhammad Mumtaz Khan, Ghulam Saqulain, Sabeen Nasir, Naveed Sharif.
Spontaneous regression of primary papillary microcarcinoma thyroid after metastasizing to right supraclavicular and cervical lymph nodes.
Pak J Pathol Jan ;27(4):178-82.

Objective: Papillary microcarcinoma thyroid is a rare focus of malignancy within normal thyroid or in adenomatous colloid goiter. Our aim is to bring to focus the possibility of papillary microcarcinoma thyroid presenting as lymph node metastasis without thyroid enlargement. Case report: We present a case who initially reported with a small cystic to nodular swelling in the right supraclavicular lymph node. The biopsy revealed it to be lymph node showing metastatic papillary carcinoma thyroid. Clinically there was no enlargement of the thyroid gland. Thyroid function tests, neck ultrasound and thyroid scan were normal. Therefore, a diagnosis of metastatic papillary microcarcinoma thyroid was made. Another lesion appeared in the right cervical region after six months having identical morphology as earlier case. Again, a battery of tests were performed including neck ultrasound and thyroid scan which were normal. TTF-1 immunohistochemical stain was strongly positive in both the cases which confirmed thyroid their origin. The patient did not opt for surgery; however, there was no recurrence after more than 10 years follow up. Conclusion: The possibility of papillary microcarcinoma thyroid as a metastatic lesion in a lymph node biopsy must be kept in mind even in the absence of thyroid enlargement.

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