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Fig. 5 —43-year-old woman with known papillary thyroid carcinoma. Total thyroidectomy with bilateral modified radical neck dissection was performed. In operative field, right sympathetic chain had thyroid adhesions and was difficult to dissect. Right ptosis developed on first postoperative day. Preoperative CT image of neck depicts heterogeneous masses in both lobes of thyroid and metastasis in both level IV lymph nodes (long arrows). Mass in right lobe shows exophytic growth and disruption of fat plane (short arrows) between mass and prevertebral muscle.