Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2023; 11(29): 7253-7257
Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7253
Submandibular solid-cystic mass as the first and sole manifestation of occult thyroid papillary carcinoma: A case report
Geng-Yu Chen, Tong Li
Geng-Yu Chen, Tong Li, Thyroid and Breast Surgery, The Fourth People’s Hospital of Jinan City, Jinan 250021, Shandong Province, China
Author contributions: Chen GY collected the clinical data; Li T wrote the manuscript and analyzed the data.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tong Li, MD, Surgeon, Thyroid and Breast Surgery, The Fourth People’s Hospital of Jinan City, No. 50 Shifan Road, Jinan 250021, Shandong Province, China. litong198234@163.com
Received: August 28, 2023
Peer-review started: August 28, 2023
First decision: September 4, 2023
Revised: September 11, 2023
Accepted: September 26, 2023
Article in press: September 26, 2023
Published online: October 16, 2023
Processing time: 46 Days and 0.3 Hours
Abstract
BACKGROUND

Occult thyroid papillary carcinoma (OTPC) is typically characterized by initial presentation with cervical lymph node metastasis and can be detected through ultrasound. However, the initial and sole manifestation was a submandibular solid-cystic mass. High-frequency ultrasound, enhanced multislice computed tomography (CT) scan, and thyroid function tests revealed no abnormalities, which is relatively uncommon.

CASE SUMMARY

A 24-year-old Chinese female, who studied at a university in Shandong Province, presented to the clinic in June 2019 with a right submandibular mass that she had noticed 2 mo earlier. Clinical examination revealed a 2-cm, nontender, movable solid-cystic mass in the submandibular region, with no palpable thyroid mass observed. Ultrasonography revealed a 2.0 cm × 1.1 cm solid-cystic mass in the right submandibular region, and the thyroid gland showed no abnormalities. CT scan and 131I whole body follow-up scan showed that there were no abnormalities in the thyroid. However, cytology and pathology showed papillary tumor cell clusters, consistent with papillary thyroid carcinoma. Thus, we performed total thyroidectomy and right neck lymph node dissection. The pathology revealed the thyroid was detected as classical thyroid micropapillary carcinoma, and lymph nodes of levels VI central and levels II, III, IV, V on the right side showed no tumor metastasis. The patient was followed up for 2 years without significant recurrence.

CONCLUSION

The presentation of a submandibular solid-cystic mass as the primary and solitary indication of OTPC is relatively uncommon. Fine needle aspiration is advised for evaluating neck masses.

Keywords: Occult thyroid carcinoma, Submandibular mass, Ultrasound, Fine needle aspiration, Case report

Core Tip: Occult thyroid papillary carcinoma is rare. However, submandibular solid-cystic mass was the initial and sole manifestation, ultrasound and computed tomography scan showed no abnormalities in the thyroid gland, which is relatively rare. We report the case with submandibular solid-cystic mass as the first and sole manifestation was diagnosed with papillary thyroid carcinoma after surgery.