Papillary Thyroid Carcinoma with Aggressive Histological Variants Masquerading as a Cystic Lymphangioma: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Introduction: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy and generally carries an excellent prognosis.However, certain histological variants, such as the tall cell and hobnail subtypes, are associated with more aggressive behavior, local invasion, and poorer outcomes.Presentation as a large cystic cervical mass mimicking a benign lesion such as a cystic lymphangioma is exceptionally uncommon and can lead to a substantial diagnostic and therapeutic challenge. Case presentation:We report the case of a 28-year-old man, with a history of blindness of undetermined etiology since the age of 11, who presented with a progressively enlarging right laterocervical mass evolving over 1 year.Computed tomography revealed a large lobulated mass with mixed cystic and solid components and calcifications, measuring 94 mm, displacing the aerodigestive axis and the thyroid gland, radiologically suggestive of a cystic lymphangioma.Intraoperatively, the mass was found to be firm, fixed, and densely adherent to the aerodigestive axis and adjacent musculature, precluding complete resection.Histopathological examination of the surgical specimen revealed classic-type papillary thyroid carcinoma of high grade, with foci of tall cell and hobnail cell subtypes.Conclusion: This case underscores that papillary thyroid carcinoma, particularly with aggressive histological variants, can present atypically as a large cystic cervical mass mimicking benign lesion such as cystic lymphangioma.Preoperative radiological findings should not exclude malignancy, and histopathological confirmation remains essential, especially in cases with unusual local invasion.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7203735826