Cystic metastasis of the lateral neck mass: A case of occult thyroid adenocarcinoma

ABSTRACT

Carcinoma of the thyroid gland usually presents as a midline expansive neck mass. The mass may be painful or evoke as its initial manifestation some type of aerodigestive dysfunction such as dysphagia, hoarsness, hemoptysis, or dyspnea. Less frequently, metastatic lateral neck mass is the first sign or symptom of thyroid cancer. The ultrasonic and Fine needle aspiration biopsy pattern of the lateral cystic neck mass are of importance in the differentiation of a cavitated lymph node from a brancheal cleft cyst. This report focuses on a case in which a solitary lateral neck mass was the sole initial presentation and clinically exhibited the usual appearance of brancheal cleft cyst. Accordingly, it is suggested that, in patients presenting with an asymptomatic solitary lateral cystic neck mass, the possibility of metastasis from an occult thyroid cancer should be considered and consent for definitive surgery should be obtained.