Article Sections

Introduction

The thyroid gland can be involved with both primary and metastatic malignancy.  Major categories of primary thyroid cancer include:

  • Papillary thyroid cancer
  • Follicular thyroid cancer
  • Oncocytic carcinoma of the thyroid (Hürthle cell cancer)
  • Anaplastic thyroid cancer
  • Medullary thyroid cancer
  • Primary thyroid lymphoma

Clinical presentation

Thyroid malignancy most commonly presents as a nodule or mass in the lower neck.  Incidental discovery during imaging of the neck for other reasons is common, especially with less aggressive tumors.  Compression of surrounding structures may produce hoarseness, dysphagia, or neurologic compromise.  Obstruction of the vena cava may lead to Pemberton sign (ie, facial plethora induced by bilateral arm elevation).  Definitive diagnosis is usually made with fine needle aspiration biopsy of the mass.  Subsequent staging is typically accomplished with CT scan (or MRI) of the neck.

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