Unusual presentation of metastatic thyroid cancer without a primary: role of diagnostic imaging in a daily clinical setting

Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland. In 21-90% of the patients occult lymph node metastases may occur. The case reported here in describes a women who underwent a complete thyroidectomy for multinodular goiter and who presented an enlarged lymph node on the left side of the neck, which was demonstrated a metastasis from PTC. The patient underwent radiological investigations with CT and FNAB. The pathological examination diagnosed a papillary thyroid cancer metastases. The pT underwent a I131 total body scan, negative for secondary localization.