Thyroid Carcinoma

CT scan verified thyroid gland localization of this asymptomatic neck mass that proved to be papillary thyroid carcinoma on needle aspiration biopsy. Thyroidectomy confirmed the diagnosis of cancer.

A 28-year-old woman complained of an asymptomatic, gradually enlarging neck mass, present for about 2 months. This was an incidental complaint voiced during a rosacea follow-up visit.

Key point: Physical examination revealed a firm, non-transilluminating (solid) mass located on the lower, anteromedial neck. Placement just below the thyroid cartilage suggested thyroid gland localization, which was verified by CT scan. Scintigraphy revealed a “cold” thyroid nodule. Fine-needle aspiration biopsy strongly suggested papillary thyroid carcinoma.

Treatment: The diagnosis of cancer was verified at the time of thyroidectomy. A regimen of thyroid hormone replacement was subsequently started.

Note: There are many etiologies of neck masses. Along with a detailed patient history, a CT scan, ultrasonogram, MRI scan, radionuclide scan, and fine-needle aspiration biopsy may help determine the precise cause. Appropriate therapy follows accurate diagnosis.

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