Li Xiaxia, Fan Guokang, Lou Zhewei
Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Ear Nose Throat J. 2025 Jul 22:1455613251359427. doi: 10.1177/01455613251359427.
Ectopic thyroid carcinoma is rare. We present an exceptionally rare case of primary retropharyngeal ectopic papillary thyroid carcinoma (PTC) coexisting with an orthotopic thyroid goiter, aiming to enhance clinical awareness of this condition and to emphasize the importance of comprehensive management of both the ectopic lesion and the orthotopic thyroid.
Case report and literature review.
A 29-year-old male with a 3-year history of pharyngeal foreign body sensation underwent laryngoscopy and noncontrast CT/MRI, revealing a 2.0 × 3.5 cm left retropharyngeal mass. The mass was confirmed as papillary carcinoma via transoral excision. Postoperative contrast-enhanced CT identified metastatic-level VI lymphadenopathy, prompting total thyroidectomy with central neck dissection. Histopathology verified ectopic PTC with central node metastasis (1/20 nodes). Orthotopic thyroid exhibited nodular goiter without malignancy. No recurrence was observed during 36 months of follow-up.
This case highlights retropharyngeal ectopic PTC's diagnostic complexity in a patient with orthotopic thyroid gland. Management of ectopic thyroid carcinoma may be guided by thyroid carcinoma guidelines, given its rarity. Total thyroidectomy is recommended to exclude concurrent thyroid malignancy and enable thyroglobulin-based surveillance.
异位甲状腺癌较为罕见。我们报告一例极为罕见的原发性咽后异位乳头状甲状腺癌（PTC）与原位甲状腺肿并存的病例，旨在提高对该病症的临床认识，并强调对异位病变和原位甲状腺进行综合管理的重要性。
病例报告及文献复习。
一名有3年咽部异物感病史的29岁男性接受了喉镜检查及非增强CT/MRI检查，发现左咽后有一个2.0×3.5 cm的肿块。经口切除后，肿块被确诊为乳头状癌。术后增强CT发现Ⅵ区淋巴结转移，遂行全甲状腺切除术及中央区颈淋巴结清扫术。组织病理学证实为异位PTC伴中央区淋巴结转移（20个淋巴结中有1个转移）。原位甲状腺表现为结节性甲状腺肿，无恶性病变。随访36个月未观察到复发。
该病例凸显了在有原位甲状腺的患者中咽后异位PTC的诊断复杂性。鉴于其罕见性，异位甲状腺癌的治疗可遵循甲状腺癌指南。建议行全甲状腺切除术以排除同时存在的甲状腺恶性肿瘤，并便于进行基于甲状腺球蛋白的监测。
