ABSTRACT
Papillary carcinoma of the thyroid is the most common thyroid cancer in children. It usually occurs in the teenage female and presents as a mass within the thyroid itself. In the great majority of cases the only presenting sign is a neck mass. In a high percentage (60-80%) there are also palpable lymph nodes. A 8 years old female patient was admitted because of palpable neck mass and miliary shadow in chest X-ray. On examination, a soft nontenter nodular mass 1x1 cm in size was palpated at supraclavicular area of left mid-neck. In chest X-ray and CT, well demarcated nodular milialy infiltration was fully distributed in both lung. After the initial treatment failure for the miliary tuberculosis, the fine needle aspiration biopsy was performed. The Papillary carcinoma of the thyroid was diagnosed. Total thyroidectomy and entire lymph node excision were performed, followed by radioiodine ablation and hormonal therapy. The patient has been improved clinically. We are reporting a case of thyroid papillary carcinoma presenting as a pulmonary miliary infiltration with brief review of the literature.