Papillary carcinoma arising in a presumed thyroglossal duct cyst with associated lateral neck extension

Primary papillary thyroid carcinoma arising in a thyroglossal duct cyst (TGDC) is a rare but well-documented phenomenon. Typically, patients present with a painless, midline neck mass found to be a TGDC on routine imaging (computed tomography or ultrasound), and undergo a Sistrunk procedure for removal. Papillary thyroid carcinoma is then found incidentally within the cyst on histopathologic examination. We describe a unique case of papillary thyroid carcinoma as a lateral neck lesion without clinical, radiographic or histologic evidence of a TGDC or primary neoplasm in the thyroid