CTICasesPapillary Thyroid Carcinoma
Imaging findings
Neck and chest CT in a 40-year-old patient shows a large, lobulated, heterogeneously enhancing thyroid mass with internal necrotic areas and punctate calcifications. The mass extends into the upper chest, directly invades the manubrium, narrows adjacent mediastinal vessels, and invades the spinal canal. Multiple necrotic cervical and mediastinal lymph nodes are present.
Key takeaways
While papillary thyroid carcinoma is typically an indolent malignancy, it can occasionally present with locally aggressive behavior, direct chest wall invasion, mediastinal extension, and epidural extension into the spinal canal. CT is critical to evaluate the extent of extrathyroidal extension, vascular involvement, and nodal metastases to guide surgical resection.
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