Occult papillary thyroid microcarcinoma manifesting only as a symptomatic lateral cervical mass: report of a case.

We report a case of occult papillary thyroid carcinoma (PTC) manifesting as a solitary lateral cervical mass. Few such cases have been reported and, to our knowledge, this is the first report of cervical lymph node involvement from thyroid cancer being so massive that it is the cause of the local symptoms. The patient, a 64-year-old man, presented with vocal cord paralysis and voice alteration and was found to have a 4 cm lateral cervical mass infiltrating the ipsilateral internal jugular vein and recurrent laryngeal nerve. The diagnosis of PTC was made preoperatively following an open-biopsy of the lesion. The patient underwent total thyroidectomy with modified radical neck dissection, followed by radioactive iodine therapy. His postoperative course was uneventful and he remains well without any signs of recurrence 7 years after the operation.