A young mans lateral neck cyst that has existed for years, a visual diagnosis?

Patient, 36, progressive neck swelling since 3 to 4 years on the left. No clinical complaints. Sonographic left supraclavicular cyst measuring 9x7cm with a capsule. No suspicious lymphnode in levels I-V. Additional findings: benign, impressive grade III goiter with cystic structures caudally. Benign findings on thyroid puncture. Overall, the patient insisted on a multifocal cystic finding DD lymphangiomas. Thyroidectomy with resection of the cystic findings and the lateral neck cyst was recommended. At the patient's request, only resection of the lateral neck cyst and a CT of the neck were carried out. The CT performed revealed enlarged mediastinal and right hilar lymph nodes. In September 21, resection of the lateral neck cyst took place. The histological findings showed a cystic lymph node metastasis of a papillary thyroid carcinoma on the left cervical in the L5. According to the tumor board decision, thyroidectomy was carried out with neck dissection level II-VI on the left and VI on the right. The MRI revealed normal kidney cysts. The EBUS-LK puncture revealed no evidence of malignancy. The procedure took place in November 21. There were several lymph nodes suspicious for metastases in the retroclavicular and retrosternal bds. The histol. Findings revealed a multifocal papillary microcarcinoma of the left SD PT1a(m=4)pN1b L0 V0 Pn0 with 5 LN metastases in the central compartment. The large SD nodule was benign. Adjuvant radioiodine therapy was carried out. The patient is currently tumor-free.