Bilateral papillary thyroid cancer with normal aberrant thyroid tissue

Ectopic thyroid tissue, 90% presenting in lingual zone, is often scanned by ultra-sonography or computed tomography. Most surgeons regard ectopic thyroid as metastatic foci from thyroid cancer, thus resection is recommended. Here, we reported a man with bilateral papillary thyroid cancer, accompany with normal ectopic thyroid tissue in right sternocleidomastoid muscle. In this case, we highlighted: (i) It is rarely reported that ectopic normal thyroid tissue presented in sternocleidomastoid muscle. (ii) The ectopic thyroid tissue may not always be metastatic foci even though bilateral thyroid tumors were confirmed to be papillary cancer. (iii) Contrary to radical excision of all ectopic thyroid tissue, we advocate that only patients who need to receive the radioactive iodine therapy after total thyroidectomy should remove the ectopic normal thyroid tissue.