Case history

Case history

A 40-year-old woman is found to have a 2-cm right-sided thyroid nodule during a routine physical examination. She has no history of head and neck irradiation or family history of thyroid cancer. The nodule is firm and mobile in relation to the underlying tissue. Vital signs and the remainder of the examination are normal.

Other presentations

Malignant thyroid nodules may be incidentally found on neck ultrasound, positron emission tomography (PET) scan, or computed tomography (CT) scan, or may occur in multinodular goiters.[12] Occasionally, patients present with advanced disease. They will have hoarseness, dyspnea, dysphagia, or cough.[1] Rapidly growing neck mass or rapid transformation of a long-standing goiter within a few days to a few weeks is characteristic of anaplastic thyroid cancer.[3][13]​ Cervical lymphadenopathy is a common presentation of medullary thyroid cancer.[14] Uncommonly, patients have a multiple endocrine neoplasia (MEN) syndrome.[4] Rarely, the thyroid itself is involved by distant metastasis from lung, breast, melanoma, or kidney tumors, or by direct extension from malignancies in the larynx and pharynx. Also rarely, thyroid cancer presents with distant lung or bone metastasis or pathologic bone fracture. Very rarely, thyroid cancer causes thyrotoxicosis.[15]

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