A case of occult thyroid carcinoma revealed by cervical lymph node metastasis

A 26-year-old man visited our hospital with right neck swelling, which was initially diagnosed as a lateral cervical cyst. After follow up for approximately 5. 5 years, the right neck swelling was diagnosed as cervical lymph node metastasis of thyroid papillary carcinoma on extirpation of the cyst. An additional operation, right lobectomy of the thyroid grand with unilateral neck dissection, was performed, but pathologically, no carcinoma was detected in the specimen. It was suggested that the carcinoma was missed because it was present between sections of the specimen. Finally we diagnosed the case as occult thyroid carcinoma. There was no evidence of recurrence a year after surgery. The case is being closely followed up.