Journal List > Int J Thyroidol > v.8(2) > 1082723

Int J Thyroidol. 2015 Nov;8(2):190-193. Korean.
Published online November 30, 2015.
Copyright © 2015. the Korean Thyroid Association. All rights reserved.
Papillary Thyroid Cancer from Lateral Aberrant Thyroid Masquerading as Cervical Metastasis from Larynx Cancer: A Case Report
Jeon Ha Choi,1 Choon Dong Kim,1 Eun Ju Kim,2 and Seung Woo Kim1
1Department of Otorhinolaryngology-Head and Neck Surgery, Veterans Health Service Medical Center, Seoul, Korea.
2Department of Pathology, Veterans Health Service Medical Center, Seoul, Korea.

Correspondence: Seung Woo Kim, MD, Department of Otorhinolaryngology-Head and Neck Surgery, Veterans Health Service Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul 134-791, Korea. Tel: 82-2-2225-1384, Fax: 82-2-2225-1385, Email:
Received February 02, 2015; Revised March 25, 2015; Accepted April 12, 2015.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aberrant or ectopic thyroid in lateral neck is a rare developmental anomaly. Furthermore, the primary thyroid carcinoma arising in ectopic thyroid is extremely rare, only a few cases have been reported so far in English literature. We report a 64-year-old male with left transglottic cancer and primary papillary carcinoma from lateral aberrant thyroid in left lateral neck. Preoperatively, we diagnosed as transglottic cancer with ipsilateral neck metastasis. The patient underwent total laryngectomy, left selective neck dissection and left thyroidectomy. Finally, the patient was diagnosed as left transglottic cancer and papillary carcinoma from lateral aberrant thyroid. Surgeons should take into account a primary ectopic thyroid carcinoma arising in lateral neck may co-exist with another type of head and neck tumor.

Keywords: Aberrant thyroid; Papillary cancer


Fig. 1
Preoperative imaging studies. (A) Neck CT scan shows 1.2×2.1 cm sized enhanced soft tissue mass in left true vocal cord (arrow). (B) Neck CT scan shows 1.3×1.2 cm sized nodule in left thyroid gland (arrow). (C) Neck CT scan shows 0.8×0.9 cm sized iso-dense round mass in left level III (arrow). (D) T2-weighted MRI shows slight high signal intensity mass in left level III (arrow). (E) Ultrasonographic image shows about 1×0.8 cm sized ovoid hypoechogenic nodule in the left lateral neck (asterik).
Click for larger image

Fig. 2
Preoperative PET CT scans. It shows strong FDG uptake on left vocal cord (standard uptake value, 20.4), mild uptake on left level III (SUV, 2.2) (white arrow).
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Fig. 3
Pathologic findings. (A) Gross photograph shows the specimen of total laryngectomy with left selective neck dissection and left thyroidectomy. The white arrow indicates small lymph node in level III. (B) Microscopic findings: The fronds of tissue have thin fibrovascular cores and an overall papillary pattern. The black arrow indicates papillary architectures (H&E, ×100).
Click for larger image

1. Paresi RJ Jr, Shah D. Hashimoto's thyroiditis presenting as an enlarging submandibular mass in a patient with a lingual thyroid. Otolaryngol Head Neck Surg 2005;132(5):806–808.
2. Huang TS, Chen HY. Dual thyroid ectopia with a normally located pretracheal thyroid gland: case report and literature review. Head Neck 2007;29(9):885–888.
3. Kang JH, Choi KM, Kim YJ, Kim SW. A case of anaplastic carcinoma arising ectopic thyroid. Korean J Head Neck Oncol 2009;25(2):153–155.
4. Mansberger AR Jr, Wei JP. Surgical embryology and anatomy of the thyroid and parathyroid glands. Surg Clin North Am 1993;73(4):727–746.
5. De Felice M, Di Lauro R. Thyroid development and its disorders: genetics and molecular mechanisms. Endocr Rev 2004;25(5):722–746.
6. Frantz VK, Forsythe R, Hanford JM, Rogers WM. Lateral aberrant thyroids. Ann Surg 1942;115(2):161–183.
7. Yoon JS, Won KC, Cho IH, Lee JT, Lee HW. Clinical characteristics of ectopic thyroid in Korea. Thyroid 2007;17(11):1117–1121.
8. Barber TW, Lee ST, Lim E, Lim HK, Scott AM. Benign ectopic multinodular thyroid tissue in the submandibular region with a coexistent normotopic multinodular thyroid gland harboring papillary thyroid cancer. Clin Nucl Med 2010;35(8):618–619.
9. Maceri DR, Babyak J, Ossakow SJ. Lateral neck mass. Sole presenting sign of metastatic thyroid cancer. Arch Otolaryngol Head Neck Surg 1986;112(1):47–49.
10. Ohnishi H, Sato H, Noda H, Inomata H, Sasaki N. Color Doppler ultrasonography: diagnosis of ectopic thyroid gland in patients with congenital hypothyroidism caused by thyroid dysgenesis. J Clin Endocrinol Metab 2003;88(11):5145–5149.
11. Shah BC, Ravichand CS, Juluri S, Agarwal A, Pramesh CS, Mistry RC. Ectopic thyroid cancer. Ann Thorac Cardiovasc Surg 2007;13(2):122–124.
12. Cabibi D, Cacciatore M, Guarnotta C, Aragona F. Immunohistochemistry differentiates papillary thyroid carcinoma arising in ectopic thyroid tissue from secondary lymph node metastases. Thyroid 2007;17(7):603–607.
13. Brindle R, Mullan D, Yap BK, Gandhi A. Thyroid incidentalomas discovered on positron emission tomography CT scanning - Malignancy rate and significance of standardised uptake values. Eur J Surg Oncol 2014;40(11):1528–1532.
14. Shaha AR, Shah JP, Loree TR. Patterns of nodal and distant metastasis based on histologic varieties in differentiated carcinoma of the thyroid. Am J Surg 1996;172(6):692–694.
15. Seven H, Gurkan A, Cinar U, Vural C, Turgut S. Incidence of occult thyroid carcinoma metastases in lateral cervical cysts. Am J Otolaryngol 2004;25(1):11–17.