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case_images: A 16 year old girl with bilateral papillary thyroid carcinoma. (A) Axial enhanced CT neck showing enhancing mass lesion involving right thyroid lobe. The left lobe appears to be normal in CT scan.
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case_images: CT neck showed an enhancing mass lesion in right thyroid lobe with abnormally dilated channels (Fig. 1, Fig. 2).
case_images: Selective right external carotid angiogram showing highly vascular fistulous type of lesion fed by superior thyroidal artery and draining into internal jugular vein corresponding to vascular lesion visible on CT neck giving rise the suspicion of thyroid paraganglioma.
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case_images: Selective angiogram of right external carotid artery revealed high flow fistulous type of lesion fed by superior thyroidal artery, draining into internal jugular vein (Fig. 3).
case_images: Post right thyroidectomy and isthmectomy CT neck coronal enhanced view showing metastatic nodes on right side at level IV and level VI compressing the internal jugular vein.
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case_images: Follow up CT neck (Fig. 4) showed no mass or nodule in left lobe of thyroid.
case_images: Post-operative right thyroidectomy and isthmectomy thyroid scan showing radiotracer uptake in left lobe of thyroid indicating residual thyroid papillary carcinoma.
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case_images: Post operatively thyroid scan (Fig. 5) was repeated to ensure no residual tumor.