Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy often presenting with multifocal solid thyroid lesions or cystic lymph nodes and has a good prognosis. A large solid cystic appearance of the primary is a rare entity that is associated with locally advanced disease. Extrathyroidal extension (ETE) is one of the few risk factors for local recurrence. We present a case of a 58-year-old lady who had presented with a cystic large thyroid tumor, papillary cancer on cytology, solid cystic on imaging with laryngeal tract invasion, and pharyngeal involvement at the surgery. Adequate preoperative planning and intraoperative measures are essential to achieve a good outcome.
Zhang J, Fu C, Cui K, et al. Papillary thyroid carcinoma with tracheal invasion. Medicine (Baltimore) 2019;98(38):e17033. DOI: 10.1097/MD.0000000000017033.
Metere A, Aceti V, Giacomelli L. The surgical management of locally advanced well-differentiated thyroid carcinoma: changes over the years according to the AJCC 8th edition Cancer Staging Manual. Thyroid Res 2019;12(1):10. DOI: 10.1186/s13044-019-0071-3.
Kim H, Kim JA, Son EJ, et al. Preoperative prediction of the extrathyroidal extension of papillary thyroid carcinoma with ultrasonography versus MRI: a retrospective cohort study. Int J Surg 2014;12(5):544–548. DOI: 10.1016/j.ijsu.2014.03.003.
Brauckhoff K, Biermann M. Multimodal imaging of thyroid cancer. Curr Opin Endocrinol Diabetes Obes 2020;27(5):10. DOI: 10.1097/MED.0000000000000574.
Seo YL, Yoon DY, Lim KJ, et al. Locally advanced thyroid cancer: can CT help in prediction of extrathyroidal invasion to adjacent structures? Am J Roentgenol 2010;195(3):W240–W244. DOI: 10.2214/AJR.09.3965.
Hoang JK, Branstetter BF, Gafton AR, et al. Imaging of thyroid carcinoma with CT and MRI: approaches to common scenarios. Cancer Imaging 2013;13(1):128–139. 12. DOI: 10.1102/1470-7330.2013.0013.
Baser B, Munjal VR, Roy MT. Papillary carcinoma of thyroid with an unusual presentation. Indian J Otolaryngol Head Neck Surg 2015;67(S1):145–148. DOI: 10.1007/s12070-014-0746-y.
Schwaiger K, Koeninger F, Wimbauer J, et al. Occult papillary thyroid cancer presenting as cystic metastasis of the lateral neck: a case report. Medicine (Baltimore) 2019;98(30):e16659. DOI: 10.1097/MD.0000000000016659.
Patil VS, Vijayakumar A, Natikar N. Unusual presentation of cystic papillary thyroid carcinoma. Case Rep Endocrinol 2012;2012:1–4. DOI: 10.1155/2012/732715.