BMC Ear, Nose and Throat Disorders

Background: The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the English literature before. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis. Case presentation: The case presented here is a 22-year-old woman who was referred to our clinic with complaints of painless neck mass, dysphagia and hoarseness for two years. After radiologic and pathological examination, the mass thought to be relevant with the thyroid gland. Peroperatively, the tumor was found to originate from the superior pole of the right thyroid gland, with a narrow stalk, and extended following the neurovascular bundle to the lower part of the parapharyngeal space. The bulk was removed via transservical approach with total thyroidectomy. Conclusion: The occurrence of the follicular variant of papillary thyroid carcinoma in the parapharyngeal space is extremely rare. The management of this rare case was discussed with the review of literature. Background The parapharyngeal space, an inverted pyramid-shaped region, extends from the skull base to the greater cornu of the hyoid bone [1]. Tumors of this space are rare, accounting for 0, 5 % of head and neck neoplasms [2]. Only 20% of these neoplasms are malignant and 50% of these neoplasms arise from the deep lobe of the parotid gland or minor salivary glands [3]. Although thyroid neoplasms are the most common endocrine tumors in head and neck, thyroid cancer is a relatively uncommon neoplasm [4]. Presentation of the thyroid carcinoma as a neck mass extending into the PPS is very rare [5]. A 22-year-old female who has papillary carcinoma of thyroid extending to the parapharygeal space is presented in this case report. Case presentation A 22-year-old female patient was referred our clinic for evaluation of a painless neck mass, hoarseness and dysphagia. She first noticed the mass in the upper right neck two years earlier without any symptoms. Her medical and family histories were unremarkable. Physical examination revealed a submucosal mass in the right lateral oropharyngeal wall with medial displacement of the right tonsil. A non-tender, firm, mobile mass measuring 4 × 4 cm. was detected deep to the right sternocleidomastoid muscle below the angle of the mandible. Superior extent of the mass could not be palpated in the neck. The telescopic examination of the larynx demonstrated a right sided, smooth mass narrowing the rima glottis. There were not any cranial nerve deficits other than the paralysis of the right vocal cord. The computed Published: 01 March 2006 BMC Ear, Nose and Throat Disorders2006, 6:3 doi:10.1186/1472-6815-6-3 Received: 16 August 2005 Accepted: 01 March 2006 This article is available from: http://www.biomedcentral.com/1472-6815/6/3 © 2006Cetik et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.