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Patient case: Thyroid Cancer

Discussion

A 45-year-old female presents with a painless swelling in the front of her neck that she noticed a few months ago. Recently, she has experienced mild difficulty swallowing and a hoarse voice. She denies any significant weight loss, fatigue, or changes in appetite. Upon physical examination, a firm, non-tender nodule is palpable in the right lobe of the thyroid. There is no visible lymphadenopathy.

Ultrasound of the thyroid shows a hypoechoic solid nodule with irregular borders and microcalcifications in the right lobe. A fine-needle aspiration biopsy (FNAB) is performed, revealing papillary thyroid carcinoma. The patient is referred for surgical management, and a total thyroidectomy is recommended.

Post-surgery, the patient is started on thyroid hormone replacement therapy and will require regular follow-up to monitor for recurrence.

Questions
1. What is the most common presenting symptom in the patient with thyroid cancer?

A) Painful neck swelling

B) Painless neck swelling

C) Weight loss

D) Palpitations

2. Which diagnostic test confirmed the diagnosis of thyroid cancer in the patient?

A) Ultrasound

B) CT scan

C) Fine-needle aspiration biopsy

D) Blood test

3. What type of thyroid cancer was diagnosed in the patient?

A) Follicular thyroid carcinoma

B) Medullary thyroid carcinoma

C) Papillary thyroid carcinoma

D) Anaplastic thyroid carcinoma

4. What is the typical treatment plan for a patient diagnosed with papillary thyroid carcinoma?

A) Chemotherapy

B) Radiation therapy

C) Total thyroidectomy and hormone replacement

D) Watchful waiting

Reveal answers

Answers

1. B) Painless neck swelling

2. C) Fine-needle aspiration biopsy

3. C) Papillary thyroid carcinoma

4. C) Total thyroidectomy and hormone replacement

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