Papillary thyroid micro carcinoma masquerading as branchial cleft cyst

Papillary thyroid microcarcinomas (PTMC) have excellent prognosis, although a few may present with metastasis to cervical lymphnodes. We present one such case of PTMC presenting as a left neck cyst without evidence of palpable primary thyroid nodule either clinically or on imaging. On histopathological examination of the excised cyst and subsequent total thyroidectomy, a final diagnosis of PTMC with cervical lymphnode metastasis undergoing cystic degeneration was given. We conclude that PTMC may also present as lateral neck cyst with an occult primary in thyroid gland.