title: Metastatic papillary thyroid carcinoma with absence of tumor focus in thyroid gland.
abstract: BACKGROUND
  Papillary thyroid carcinoma presenting as isolated cervical lymphadenopathy with clinically and histologically normal thyroid gland is rarely reported.
  
  
  METHODS
  We report a case of 31 years old female who presented with a left cervical mass and clinically normal thyroid gland. After inconclusive FANC, excision biopsy of her cervical lymph nodes revealed metastatic papillary thyroid carcinoma. The patient subsequently underwent total thyroidectomy with bilateral lymph node dissection. Interestingly pathological examination showed no primary carcinoma in the gland. Postoperative radioactive iodine scan revealed no other metastasis.
  
  
  CONCLUSIONS
  Total thyroidectomy is the next best step despite clinically and radiologically normal appearing thyroid gland once cervical lymph nodes are proven to be metastatic in nature followed by a RAI therapy to treat occult foci of PTC.
authors.affiliation: Department of Medicine, Queens Hospital Center, Jamaica, NY, U.S.A.
authors.forename: Anil
authors.initials: A
authors.lastname: Singh
authors.forename: Radu
authors.initials: R
authors.lastname: Butuc
authors.forename: Ricardo
authors.initials: R
authors.lastname: Lopez
keywords: computed tomography (CT); fine needle aspiration cytology (FNAC); papillary thyroid carcinoma (PTC); papillary thyroid micro carcinoma (PTMC)