Total thyroidectomy 5 years prior to study for a 6 cm thyroid nodule followed by radioactive iodine. Recurrent metastatic disease was addressed by central and left lateral neck dissection with a retropharyngeal lymph node removal 3 years later.  The patient had a PET scan which revealed left oropharyngeal/retropharyngeal node as well as miliary lung lesions. Her laboratory values included thyroglobulin Ab 26 and thyroid peroxidase Ab 35.

Final Pathological Diagnoses:

A) Left Parotid Tail Lymph Node (Biopsy): No malignancy identified in one lymph node (0/1).

B) Left Retropharyngeal Lymph Node(Excision): Metastatic papillary thyroid carcinoma involving one lymph node (1/1).