PMC3623391_01
Computed tomography of neck showing diffuse enlargement of right lobe of thyroid, came out as papillary follicular cell variant thyroid carcinoma pT2N1.
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Her past surgical history showed that she underwent total thyroidectomy and lymph node dissection for follicular variant papillary thyroid carcinoma pT2N1cM0 (Figure 1) in March 2002, followed by radioactive iodine (RAI) ablation 150 mCi in May 2002, and RAI ablation 150 mCi in July 2003 for raised serum thyroglobulin levels (39.3 ng/mL). 
Magnetic Resonance Cholangiopancreatography (MRCP) showing a small hypovascular 1.8 x 1.5 cm mass in the pancreatic neck, invading the superior mesenteric vein.
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Mass was abutting the superior mesenteric vein (SMV) and caused narrowing to its caliber below the confluence with splenic vein; however, superior mesenteric artery (SMA) was found normal in caliber with no sign of invasion (Figure 2).
(a) Infiltrating clusters of papillary tumor cells in pancreatic tissue parenchyma (H&E x100) and (b) follicular pattern with abundant cytoplasm (H&E x200).
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Histopathology showed 1.6 x 1.4 cm metastatic deposit in the neck of the pancreas and immunohistochemistry examination showed the positivity for TG and thyroid transcription factor-1 (TTF-1) and made confirmed diagnosis of pancreatic metastasis consistent with FV-PTC (Figure 3).