title: Occult multifocal papillary thyroid microcarcinoma presenting as a supraclavicular mass containing anaplastic thyroid carcinoma.
abstract: OBJECTIVE
  There are reports in the literature of anaplastic thyroid carcinoma in cervical lymph nodes with evidence of only papillary carcinoma in the thyroid gland. There have been no cases of this clinical scenario with only papillary microcarcinoma in the thyroid gland.
  
  
  METHODS
  We describe the case of a 60-year-old man who initially presented with an enlarged right, level 5, supraclavicular lymph node. Initial fine-needle aspiration demonstrated evidence of papillary thyroid carcinoma. The final pathologic finding in the thyroid gland showed only multiple foci of papillary thyroid microcarcinoma. The index neck mass showed evidence of anaplastic thyroid carcinoma.
  
  
  CONCLUSIONS
  This is the first instance in the literature in which anaplastic thyroid carcinoma has appeared in metastatic cervical lymph nodes with only a focus of papillary microcarcinoma in the thyroid gland. With this case, we hope to build awareness of this rare finding.
authors.affiliation: Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Deutschmann
authors.forename: Moosa
authors.initials: M
authors.lastname: Khalil
authors.forename: Shelly
authors.initials: S
authors.lastname: Bhayana
authors.forename: Shamir
authors.initials: S
authors.lastname: Chandarana
mesh_terms: D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D065646:Thyroid Carcinoma, Anaplastic; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*