Papillary carcinoma in submandibular region — a diagnostic dilemma

Papillary carcinoma is the most common variant of thyroid carcinoma. It accounts for 50–70% of thyroid malignancies in patients under the age of 40 yrs [1, 2]. Thyroid carcinoma usually presents as midline neck mass. Nodal metastasis to the neck may be the fi rst presenting symptom in papillary carcinoma thyroid. Such occult presentation of well differentiated thyroid carcinoma is seen in 10–26% of thyroid malignancies [3, 4]. In these patients, the sole presenting symptom is lateral neck mass with no evidence of primary in thyroid gland. However thyroid carcinoma presenting as submandibular swelling is not common. We report a patient of papillary carcinoma thyroid, who presented with metastatic neck swelling in the submandibular region without evidence of primary in the thyroid region.