Exophytic Papillary Thyroid Carcinoma With Anaplastic Transformation in a Cervical Lymph Node: A Case Report and Review of the Literature.
- 1General Surgery, Hospital Universitario "Dr. José Eleuterio González", Monterrey, MEX.
- 2Oncology, Hospital Universitario "Dr. José Eleuterio González", Monterrey, MEX.
- 3Pathology, Hospital Universitario "Dr. José Eleuterio González", Monterrey, MEX.
Abstract
Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid and generally follows an indolent clinical course with favorable long-term survival. However, a subset of tumors may develop aggressive histological and locoregional features, including tall-cell morphology, extensive extrathyroidal extension, and anaplastic transformation. We report an unusual presentation of PTC characterized by massive exophytic cervical growth and anaplastic transformation within a metastatic cervical lymph node. A 76-year-old man presented with a progressively enlarging right lateral cervical mass over a two-year history, accompanied by hoarseness, dysphonia, and dyspnea on moderate exertion. Physical examination revealed a 15 × 15 cm exophytic cervical mass with overlying skin ulceration. Computed tomography demonstrated extensive right cervical lymphadenopathy with central necrosis, compression of the ipsilateral internal jugular vein, airway displacement, and a heterogeneous right thyroid lobe mass with internal calcifications and poorly defined margins. The patient underwent total thyroidectomy and right radical neck dissection. Intraoperatively, an extensive cervical nodal conglomerate with infiltration of the sternocleidomastoid muscle and involvement of the thyroid cartilage was identified. Histopathological examination demonstrated papillary thyroid carcinoma of the tall-cell subtype with anaplastic transformation within cervical lymph node metastasis. This case highlights an exceptionally aggressive locoregional presentation of PTC and emphasizes the importance of comprehensive clinical, radiological, surgical, and histopathological assessment in patients presenting with bulky cervical disease. Recognition of aggressive histological features and anaplastic transformation is essential for appropriate multidisciplinary management and prognostic assessment.
Related
- Embryonic reprogramming drives anaplastic transformation in thyroid carcinoma
- Synchronous laryngeal squamous cell carcinoma and papillary urothelial carcinoma of the bladder: a case report and literature review
- Malignant transformation of intraductal papillary neoplasm of the bile duct following non-standardized biliary-enteric drainage for hepatolithiasis: two case reports and literature review
- Synchronous Metaplastic Breast Carcinoma with Mesenchymal Differentiation and Triple-Negative Invasive Papillary Carcinoma: A Case Report and Literature Review
- Case report and literature review: histologic transformation from EGFR-mutant lung adenocarcinoma to squamous cell carcinoma with newly detected SMAD4 and ATM variants
BibTeX
@article{avilan2026exophytic,
title = {{Exophytic Papillary Thyroid Carcinoma With Anaplastic Transformation in a Cervical Lymph Node: A Case Report and Review of the Literature.}},
author = {Israel Garcia Avilán and Oscar R Garcia and Jesus Delgado and Brandon Lopez Alanis and Flor Ortiz Villeda},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116776},
url = {https://europepmc.org/article/MED/42921160},
note = {CC BY},
}
RIS
TY - JOUR
TI - Exophytic Papillary Thyroid Carcinoma With Anaplastic Transformation in a Cervical Lymph Node: A Case Report and Review of the Literature.
AU - Israel Garcia Avilán
AU - Oscar R Garcia
AU - Jesus Delgado
AU - Brandon Lopez Alanis
AU - Flor Ortiz Villeda
PY - 2026
DA - 2026/09/23
JO - Cureus
DO - 10.7759/cureus.116776
UR - https://europepmc.org/article/MED/42921160
AB - Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid and generally follows an indolent clinical course with favorable long-term survival. However, a subset of tumors may develop aggressive histological and locoregional features, including tall-cell morphology, extensive extrathyroidal extension, and anaplastic transformation. We report an unusual presentation of PTC characterized by massive exophytic cervical growth and anaplastic transformation within a metastatic cervical lymph node. A 76-year-old man presented with a progressively enlarging right lateral cervical mass over a two-year history, accompanied by hoarseness, dysphonia, and dyspnea on moderate exertion. Physical examination revealed a 15 × 15 cm exophytic cervical mass with overlying skin ulceration. Computed tomography demonstrated extensive right cervical lymphadenopathy with central necrosis, compression of the ipsilateral internal jugular vein, airway displacement, and a heterogeneous right thyroid lobe mass with internal calcifications and poorly defined margins. The patient underwent total thyroidectomy and right radical neck dissection. Intraoperatively, an extensive cervical nodal conglomerate with infiltration of the sternocleidomastoid muscle and involvement of the thyroid cartilage was identified. Histopathological examination demonstrated papillary thyroid carcinoma of the tall-cell subtype with anaplastic transformation within cervical lymph node metastasis. This case highlights an exceptionally aggressive locoregional presentation of PTC and emphasizes the importance of comprehensive clinical, radiological, surgical, and histopathological assessment in patients presenting with bulky cervical disease. Recognition of aggressive histological features and anaplastic transformation is essential for appropriate multidisciplinary management and prognostic assessment.
SN - 2168-8184
ER -