Oropharyngeal Metastasis from Papillary Thyroid Carcinoma: A Rare Event

Neyaz A, Husain N, Shukla S, Arora A and Verma V

Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, India

^*Correspondance to: Husain N 

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Abstract:

Metastatic oral malignancy accounts for 1% of all oral cancers. Primary tumor sites are lung, kidney, liver, breast, female genital organs and colo-rectum. Metastasis from thyroid carcinoma to the oropharynx is very rare. Papillary thyroid carcinoma (PTC) favors lymphatic spread. Hematogenous spread rarely occurs to the lung, bones and brain. We report a rare case of a 36 year old female in whom metastatic lesion from papillary thyroid cancer presented 13 years after treatment of the primary, as an oropharyngeal mass clinically mimicking a second malignancy. CT scan revealed a mass lesion arising from posterior wall of oropharynx, partially extending over posterior wall of hypopharynx at the metastatic site, with a large primary in the left lobe of thyroid involving larynx. Histology showed a papillary adenocarcinoma which expressed CK7, thyroid transcription factor 1 (TTF1) and thyroglobulin. The review details metastasis in the oro-pharynx, metastatic sites of thyroid malignancies, more specifically differentiated thyroid carcinomas and their prognostic significance. Issues in histopathology, diagnosis of the lesion including distinguishing it from a primary PTC in a thyroglossal cyst or a lingual thyroid, differential diagnosis of other papillary lesions, interesting collision tumours are discussed. Furthermore the mechanism of lymphatic spread to oropharynx and the radiological diagnosis of metastasis and treatment strategies have been outlined.

Keywords:

Oropharynx; Metastasis; Papillary thyroid carcinoma

Cite the Article:

Neyaz A, Husain N, Shukla S, Arora A, Verma V. Oropharyngeal Metastasis from Papillary Thyroid Carcinoma: A Rare Event. Ann Clin Case Rep. 2016; 1: 1201.