Cooccurrence of Metastatic Papillary Thyroid Carcinoma andSalmonellaInduced Neck Abscess in a Cervical Lymph Node

Abstract

Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC). Salmonella species are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC and Salmonella infection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II–IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence of Salmonella Typhi. Following antibiotic sensitivity testing of the cultured Salmonella Typhi, she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management.

First case report of thyroid abscess caused by Helicobacter cinaedi presenting with thyroid storm

“…Acute suppurative thyroiditis (AST) or thyroid abscess is a rare infectious disease, representing less than 1% of all thyroid diseases because the thyroid gland has rich vascularity, a protective capsule, and high iodine content [21]. AST and thyroid abscess usually present with an acutely enlarging neck mass.…”

“…AST and thyroid abscess usually present with an acutely enlarging neck mass. The main causes are pyriform sinus fistula related to anomalies of the third and fourth branchial pouches [22], following neoplastic thyroid nodule [21, 22], Hashimoto thyroiditis [23], and penetration of the thyroid gland by foreign bodies such as fish bones [17]. Underlying comorbidities including tuberculosis, diabetes mellitus, and HIV infection appear to increase the risk of developing thyroid abscess.…”

Simultaneous occurrence of Kaposi sarcoma and tuberculosis; Kaposi sarcoma and lymphoma in the same lymph node: a report on two HIV-positive patients from Zimbabwe

“…The simultaneous occurrence of two separate lesions in the same lymph node is rare. Cases of two different tumors, one metastatic and one primary tumor or one metastatic tumor and an inflammatory lesion detected simultaneously have been reported 3,4 . However, cases with one primary tumor and one tuberculosis or two primary tumors observed together in the lymph node have been described infrequently 5,6 .…”