Authors: Daniela Bley Sebastiani , Theodora Hill , Emma Watts , Jonathan Fussey , Paul Nankivell , Neil Sharma

Abstract

Background: Subcutaneous metastases of papillary thyroid carcinoma (PTC) are rare, with only limited cases documented in the
literature. Their presence can pose diagnostic and management challenges, particularly when mimicking benign postoperative changes.
Methods: We present a retrospective study of three consecutive cases of patients with confirmed dermal metastases from PTC
identified during post-treatment surveillance. All cases of cutaneous metastases of PTC were included in this study and were managed at a single tertiary centre between 2020 and 2024.
Results: In each case, dermal metastases were detected either within previous surgical scars or within the subcutaneous tissue of
the neck, highlighting their potential to present subtly and mimic scar tissue. Diagnostic confirmation was achieved via imaging and excisional biopsy, followed by histological analysis. All patients underwent surgical intervention and received adjuvant radioactive  odine therapy. One patient required systemic therapy for progressive metastatic disease.
Conclusion: Dermal metastases from PTC remain rare but clinically significant. Imaging and biopsy with specialist histopathological support play a critical role in differentiating metastases from alternative pathology. We recommend prompt evaluation and histological examination of any new skin or subcutaneous lesion in patients with a
history of PTC. 

Keywords: Cutaneous metastases, papillary thyroid cancer, thyroid cancer, skin metastases.