A case of advanced papillary carcinoma in a 16-year-old boy is presented. While this case is typical of the indolent and locally invasive character of papillary carcinoma, it is remarkable for the extent of tumor involvment appearing as reactive lymphadenopathy. The pronounced tumor vascularity and the similarity of the needle biopsy specimen to chemodectoma both conflicted with the initial diagnostic impression. The correct diagnosis was confirmed only with definitive surgical therapy.
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