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Papillary Thyroid Microcarcinoma Presenting as Horner’s Syndrome: A Novel Clinical Presentation

Ammara Ashraf, Asad Azim, Khwaja Muhammad Azim, Talat Waseem


Background: There is considerable worldwide rising incidence of slow growing Papillary Thyroid Microcarcinoma (PTMC) due to increasing availability of modern imaging tools. Cervical lymph node metastasis still remains the most frequent site of its metastasis. Here we present a rare case of PMC resulting in Horner’s syndrome, which to our knowledge is the first case in the history of known medical literature.

Case Report: A 32 years old male presented with right posterior triangle cervical lymphadenopathy, drooping of right eyelid and anhydrosis for last 3 years. Biopsy of the swelling revealed metastatic papillary thyroid carcinoma. US neck and computerized tomography showed a mass in the right suprclavicular region closely adherent to the common carotid and the stellate ganglion area without any significant pathology within thyroid and the lung. The patient underwent total thyroidectomy with type II block neck dissection. The specimen revealed microscopic foci of papillary thyroid carcinoma involving right lobe, largest focus measuring 0.2cm. Cervical lymph nodes of level II were negative for cancer metastasis however level III, IV and V were positive for metastasis. Patient underwent I131 radio-ablation postoperatively and is disease free since operation.

Conclusion: Here we demonstrate a novel presentation of the PTMC inform of Horner’s syndrome and give brief review of literature regarding presentation of PTMC.


Horner’s syndrome; Papillary Thyroid Microcarcinoma; lymphadenopathy; Thyroid cancer.

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