Transient ischaemic attack at the admission unit: Expect the unexpected

We report a 51-year-old Caucasian male admitted at the Admission Unit of the Emergency Centre with recurrent right-sided hemiparesis suggesting transient ischemic attack. Neurological and physical examination was normal, save for the oval, painless, immobile tumor mass at the left side of the neck, near the sternocleidomastoid muscle. Imaging of brain parenchyma and vascular structures were normal. A contrast neck CT scan and neck CT angiography verified well-vascularized cervical tumor mass of the left side, without compression on the surrounding blood vessels. CT angiography excluded carotid artery stenosis, but revealed pathological vascularization of cervical tumour mass from external carotid artery. Surgical resection of the cervical mass was done and histopathological analysis revealed metastasis of papillary thyroid carcinoma.