Papillary carcinoma is the most common variant of thyroid cancer. A tumor less than 1 cm in size is labelled as the papillary thyroid micro-carcinoma (PTMC). Such tumors have an excellent prognosis, although a few may metastasize to cervical neck nodes. However, an infiltrated palpable neck node without evidence of thyroid disease is rare. Here, we report a case of an isolated submandibular metastasis from a clinically occult papillary thyroid carcinoma in a 40-year-old woman. The initial surgery was performed on the basis of the fine needle aspiration cytology (FNAC) report of basal cell adenoma vs cellular pleomorphic adenoma. The case was a total histopathological surprise as it was reported as a metastasis from papillary thyroid carcinoma. Subsequently total thyroidectomy and modified neck dissection was performed as per the standard surgical guidelines.
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