clinical features

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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