Fast Five Quiz: Can You Identify and Properly Treat Worrisome Neck Masses?

Elwyn C. Cabebe, MD

Disclosures

May 01, 2018

Fine-needle aspiration biopsy is considered the best first-line diagnostic procedure for a thyroid nodule. A thyroid biopsy can also be performed using the classic Tru-Cut or Vim-Silverman needles, but the fine-needle aspiration biopsy technique is preferable. Patients comply best with fine-needle aspiration biopsy.

At the time of diagnosis, 10%-15% of patients with papillary thyroid carcinoma have distant metastases to the bones and lungs. Initially, these patients are evaluated for pulmonary or osteoarticular manifestations (eg, pathologic fracture, spontaneous fracture).

The principal sign of thyroid carcinoma is a palpable nodule, usually solitary, in the thyroid area that has the following characteristics:

  • Painless

  • Hard consistency

  • Average size of <5 cm

  • Ill-defined borders

  • Fixed in respect to surrounding tissues

  • Moves with the trachea at swallowing

Surgery is the definitive management of papillary thyroid cancer. Approximately 4-6 weeks after surgical thyroid removal, patients may have radioiodine therapy to detect and destroy any metastasis and residual tissue in the thyroid.

For more on papillary thyroid carcinoma, read here.

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