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Joseph Junewick, MD FACR
over 10 years ago
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Metastatic Papillary Carcinoma of the Thyroid

Case Detail

Anatomy: Neck-Face
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 8 years ago
Updated: over 8 years ago
Tags: PEDS
Modality/Study Types: US
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Teenage female with Hashimoto’s thyroiditis and enlarging lymph nodes.

Case Images


Metastatic Papillary Carcinoma of the Thyroid


US – Mildly enlarged lymph node adjacent to the thyroid gland with multiple rounded hyperechoic foci in the hilum. Otherwise images showed thyromegaly with uniformly coarsened echotexture and no focal mass.


Direct tumor invasion of adjacent soft tissue and metastases to lymph nodes are highly specific signs of thyroid malignancy. At US, direct tumor invasion of adjacent soft tissues may appear as a subtle extension of the tumor beyond the contours of the thyroid gland or as frank invasion of adjacent structures. Metastases to regional cervical lymph nodes occur in about 20% of all thyroid malignancies, although most commonly in papillary thyroid carcinoma and in children more often than adults. If a focal thyroid lesion is present, metastasis is most common to the ipsilateral lymph nodes – the lateral compartment (internal jugular, spinal accessory, and supraclavicular lymph nodes) is more commonly involved than the central compartment (pretracheal, paratracheal, and thymic/perithymic lymph nodes).


Hoang JK, Lee WK, Lee M, et al. US Features of Thyroid Malignancy: Pearls and Pitfalls. Radiographics (2007); 27:847-860.


Linda Woolpert, RDMS

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