Head & Neck Case Review 2020-10

Head & Neck Case Review

October, 2020


A middle-aged man presented with a palpable neck mass and was found to have a complex 8.5 cm mass arising from the left thyroid lobe. He had no notable past medical history and no history of radiation exposure. The patient underwent hemithyroidectomy, with negative margins. Following resection, staging PET/CT/ultrasound did not demonstrate any other lesions.

Two months after hemithyroidectomy, the patient developed neck and supraclavicular swelling. PET/CT demonstrated a mass in the surgical bed extending into the mediastinum, as well as nodules in the contralateral platysma, sternocleidomastoid muscle, and supraclavicular region. A fine needle aspiration was performed of a palpable supraclavicular nodule. Images from the supraclavicular fine needle aspiration and thyroid resection are shown.



Q1. Which genetic alteration has been associated with this tumor?

  • A. BRAF V600E mutation
  • B. DICER1 mutation
  • C. RET-PTC3 fusion
  • D. Isochromosome 12p
  • E. PIK3CA mutation

Q2. Tumors occurring in infants and children generally have a favorable prognosis.

  • A. True
  • B. False



Margaret Compton, MD
Assistant Professor
Department of Pathology, Microbiology and Immunology
Vanderbilt University Medical Center, Nashville, TN