A rapidly growing hard thyroid mass with lymphadenopathy and indicators of extrathyroidal invasion e.g. hoarseness, dysphagia is suggestive of maligancy. Other important factors to elicit are a history of exposure to ionizing radiation and a family history of thyroid cancer.
The exact presentation varies with the type of tumour for example:
- papillary - very slow growth; often spreads to lymph nodes in the neck. The most common thyroid cancer
- follicular - usually middle aged women. Often spread to bones and lungs
- medullary - 20% of cases associated with MEN-II; raised calcitonin, cervical nodes often affected; may present with intractable diarrhoea and flushing
- anaplastic - usually in older patient; may present with a firm rapidly growing thyroid mass, stridor, vocal cord paralysis, weight loss
Last reviewed 01/2018