Thyroid Carcinoma

May 29, 2013
Ted Rosen, MD

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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