Metastatic Papillary Thyroid Carcinoma

Papillary thyroid cancer has the fastest increasing incidence of any thyroid malignancy and accounts for the majority of thyroid neoplasms (75-85%). It is also the most common type of thyroid cancer to develop from radiation exposure.1 Papillary thyroid cancer typically occurs in caucasions and has a female predilection (3:1 ratio), with a peak age of incidence between 25-50 years-old. It commonly presents as a painless neck mass. While no specific laboratory tests exist for diagnosis, elevation in thyroxine, triiodothyronine, or TSH can be seen. Radiology plays a crucial role in the diagnosis of papillary thyroid cancer, with ultrasound being one of the initial steps in the workup. Radioiodine (I-131) nuclear medicine studies can be used to check for distant metastases and ablate thyroid cancer. Thyroid lobectomy is the main treatment, with total thyroidectomy being reserved for higher risk tumors. We report an unusual clinical presentation of the diffuse sclerosing variant of papillary thyroid cancer in a 16-year-old male, who presented with a painless neck mass that had been growing over the past year. The patient subsequently received a total thyroidectomy and radioiodine treatment.