Contralateral metastatic papillary thyroid carcinoma and complicated by primary hyperaldosteronism: A case report

Figure 1 Thyroid ultrasound. A: Right thyroid, hypoechoic nodule (TI-RADS 4b); B: Left lateral neck mass. A mixed echogenic mass measuring approximately 6.4 cm × 4.5 cm × 5.3 cm, with color Doppler flow imaging showing clear borders and regular shape.

Figure 2 Neck and chest computed tomography scan with contrast. The largest dimension of the mass was approximately 4.0 cm × 5.5 cm, with uneven enhancement on the contrast-enhanced scan.

Figure 3 Computed tomography angiography/computed tomography venography of head and neck vasculature. A: Computed tomography angiography reconstruction, with the white arrow indicating near closure of the left internal jugular vein and formation of collateral circulation; B: Vascular reconstruction showing the left internal jugular vein compressed, with collateral circulation.

Figure 4 The adrenal pathology report indicated a benign adrenal cortical tumor. A: Cross-hair marker indicating the right adrenal tumor; B: Cross-hair marker indicating the right adrenal tumor; C: Right adrenal tumor findings: Hematoxylin and eosin staining show a benign right adrenal tumor (magnification, × 100). The observed disorganized cellular architecture, nuclear enlargement, and inflammatory/Lymphocytic infiltration indicate significant pathological changes. The proportion is 50 µm.

Figure 5 Immunohistochemistry result. A: White arrow indicating the left neck tumor; B: White arrow indicating the complete invasion of the tumor into the vagus nerve; C: White arrows pointing to the cut ends of the vagus and recurrent laryngeal nerves; D: White arrow indicating the condition following vagus-recurrent laryngeal nerve anastomosis.

Figure 6 Hematoxylin and eosin staining showing classic papillary thyroid carcinoma. A: The right thyroid (magnification, × 100); B: The left neck mass (magnification, × 100). The proportion is 50 µm.

Figure 7 The patient received radioactive iodine (I-131) treatment and TSH suppression therapy postoperatively. A: Whole-body I-131 imaging; B: I-131 imaging for targeted treatment.