Endocrine Abstracts

Differentiated thyroid carcinoma is the most common endocrine malignant tumor. Papillary carcinoma frequency in our country is 80% of thyroid neoplasia. Papillary thyroid carcinoma usually metastasizes to cervical lymph. Metastases to distant organs are rare and most often affect the lungs, liver and bones. Despite of its anatomical proximity, metastasis parotid have not been described in the existing papillary carcinomas literature. We report a case of parotid gland metastasis as the first manifestation of an occult papillary microcarcinoma.

A 30 year old male is derived to maxillofacial surgery because of the appearance of a painless tumor at the right parotid level. An ultrasound report reveals a right parotid increased in size, with a lesion in its hypoechoic interior, with lobulated margins that measure 23×22×27 mm. With these data, he is intervened, being the parotid tumor resected. Pathologic diagnosis of serous salivary gland (parotid) with papillary adenocarcinoma infiltrating intraparotid lymph nodes and does not affect resection margins. The patient is sent to endocrinology consultation for further study. Exploration of the thyroid is normal showing no nodules or lymphadenopathy. Thyroid ultrasound shows normal size of right and left lobe. A left lobe level there is a well defined solid nodule, hypoechoic of 4×6×6 mm. A cytology by FNA result suggestive of papillary carcinoma. A complete thyroidectomy with central and bilateral lymph node dissection was performed. The pathological report is: Right lobe without alterations. Left lobe with two focus of papillary carcinoma of 0.4 and 0.1 cm which do not infiltrate the capsule. We present the first case of parotid metastasis from an occult thyroid microcarcinoma.