title: Isolated metastatic papillary thyroid carcinoma masquerading as parapharyngeal space paraganglioma.
abstract: Isolated metastatic deposits of papillary thyroid carcinoma to the parapharyngeal space are rare. Herein, we describe the case of a young woman who presented with a right-sided oropharyngeal mass that was initially diagnosed as a parapharyngeal space paraganglioma. The patient opted for conservative treatment as she was asymptomatic and wished to avoid the risk of neurovascular morbidity associated with surgery. After 20 years, the patient sought treatment again for the oropharyngeal mass, which had progressively increased in size and was causing difficulty in swallowing. Repeat imaging of the affected area revealed that the mass had increased significantly in size; it also revealed the presence of a previously absent small lesion in the right lobe of the thyroid. Excision of the parapharyngeal space tumour and near-total thyroidectomy were performed; the excised specimens showed features of the follicular variant of papillary thyroid carcinoma. As papillary thyroid carcinoma that metastasises to the parapharyngeal space can masquerade as a paraganglioma, clinicians should bear in mind that an isolated metastatic deposit in the parapharyngeal space could be the first sign of occult papillary thyroid carcinoma.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, ENT Office, 4th Floor, Teaching Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. suresh6sharma@yahoo.com.
authors.forename: Suresh Chandra
authors.initials: SC
authors.lastname: Sharma
authors.forename: Prem
authors.initials: P
authors.lastname: Sagar
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.forename: Prashant
authors.initials: P
authors.lastname: Durgapal
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D002291:Carcinoma, Papillary; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D010235:Paraganglioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D051598:Whole Body Imaging