Papillary thyroid carcinoma presenting with a right preauricular and intracranial mass.

OBJECTIVE: To describe a case of a papillary thyroid carcinoma presenting with a preauricular and an intracranial mass and review the literature on the metastatic nature and invasiveness of papillary thyroid carcinoma.

METHODS:
Design: Case Report
Setting: Tertiary Private Hospital
Patient: One

RESULTS: A 46-year-old female with a 12-year anterior neck mass and a two-year right pre-auricular pleomorphic adenoma on fine needle aspiration biopsy was found to have an intracranial mass on CT- scan. Total thyroidectomy and section biopsy of the preauricular mass yielded a final histopathologic report of follicular variant of papillary carcinoma, thyroid gland; and metastatic papillary thyroid carcinoma, follicular type, pre-auricular mass. The condition of the patient precluded neurosurgical intervention and RAI therapy and she underwent 23 sessions of external radiotherapy using 46Gy with significant diminution in size of the intracranial metastasis.

CONCLUSION: Papillary thyroid malignancy may be an indolent tumor but it is capable of distant metastasis. We should be alerted by host and tumor factors which can be predictors of a more radical papillary malignant disease whose management entails proper staging evaluation and good communication of prognostic data and available, realistic therapeutic options to patients using a multidisciplinary approach.