Papillary Thyroid Carcinoma: A Case Report

Introduction: The incidence of ectopic thyroid tissue is low, which has been reported 1 in 300, 000 population and when it transformed into malignant lesion, the most common histopathology is papillary carcinoma. However, case reports that discuss papillary carcinoma is still limited due to the rarity of the case. Case Report: We present a 55 years old woman with chief complaint of a left sided neck mass that enlarge over time with a size of a ping pong ball. Examination of the neck found a solid left sided - mass measured around 4 x 4.5 cm. Thyroid ultrasonography reported a solid enlargement of the left thyroid with cystic component, 4.1 x 4.46 x 5.28 cm in size, hypoechoic, wider than tall, smooth margin with echogenic foci punctate and concluded moderately suspicious lesion. Fine needle aspiration biopsy found active macrophage cells and hemosiderin in the cytoplasm in a background of colloid and dense erythrocytes with no visible signs of malignancy. However, the excisional biopsy of the neck revealed papillary carcinoma. Tumor extirpation was performed and the thyroid gland was preserved. After the surgery, the patient denied difficulty swallowing or voice changes. The patient was discharged after 2 days of hospitalization without. Conclusion: Ectopic thyroid malignancy is a rare case and when it occurs papillary carcinoma should be suspected. Patient may present with unspecific symptoms and physical examination may reveals unremarkable findings other than a nodule in the neck. Fine needle aspiration biopsy is recommended to establish diagnosis and indicated for nodules ?1 cm with intermediate or high suspicion of malignancy in thyroid ultrasonography. Surgery and radioiodine remain the main management of ectopic thyroid malignancy.