Papillary thyroid carcinoma presenting with upper respiratory tract obstruction and pulmonary metastases

Background. Thyroid cancer is rare in children especially before the age of 10 years. Upper airway obstruction and pulmonary infiltration are rare manifestations of such tumor. Methods: An 8-year-old school girl was admitted to Mansoura University Children's Hospital for a papillary thyroid carcinoma manifested by severe upper respiratory tract obstruction. CT scan of the chest revealed multiple miliary shadows in both lungs. Results: Total thyroidectomy was performed and pathological examination confirmed the diagnosis of papillary carcinoma of the thyroid gland. The patient received ablative dose of Iodine 131 and replacement therapy of L-thyroxine. Conclusion: Thyroid cancer, although rare, should be considered for differential diagnosis of upper airway obstruction and pulmonary metastases.