Philippine E-Journals

Papillary Thyroid Carcinoma with an Unusual Metastasis to the Pterygomaxillary Space

Janice D. Magmanlac | Emmanuel S. Samson | Angelo A. Reyes | Emmanuel Tadeus S. Cruz

Discipline: Health, Medicine

 

Abstract:

Objective: To present a case of a papillary thyroid carcinoma with an unusual site of metastasis to the pterygomaxillary space

Study Design: Case Report

Setting: Tertiary Hospital

Case Report: This is the case of E.V., a 75 year old male, with a chief complaint of multiple neck masses for two years. TB lymphadenitis was initially considered however chest radiograph and PPD test were negative. CT Scan of the neck revealed a mass on the right pterygomaxillary space which appear to displace the right nasopharyngeal wall. Excision biopsy of the neck mass revealed papillary carcinoma. The pterygomaxillary space mass was biopsied via transnasal approach which revealed papillary carcinoma.

Keywords: Papillary thyroid cancer, pterygomaxillary space metastasis

Case Summary: Papillary Thyroid Carcinomas, although generally known to spread via the lymphatics, have been reported in a number of instances to metastasize to atypical locations like the heart, pancreas, liver, kidneys, adrenal glands, skin, submandibular gland, and hypopharynx. To our knowledge, this maybe the first reported case of papillary thyroid carcinoma that metastasized to the pterygomaxillary space. As such, metastatic papillary carcinoma of the thyroid should be considered in the differential diagnosis of multiple lateral neck masses and masses in the pterygomaxillary space.