Assessment of a thyroid mass Flashcards Preview

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Flashcards in Assessment of a thyroid mass Deck (6)
1

History

1. Symptoms of hyperthyroid

2. Symptoms of hypothyroid

3. Dysphonia, dysphagia, dyspnea

4. Details of growth of mass

5. Prior head/neck irradiation

6. Recent infections etc

7. Family history medullary thyroid cancer, other thyroid cancer, MEN, Cowdens

8. PMHx, social, occupational, medications, allergies...

2

Examination

1. Complete thyroid examination

2. Hyper/hypothyroid

3. Listen for dysphonia, dyspnea

4. Evidence of other malignancy

3

Investigations

1. TSH

2. T4

3. RAIU if hyperthyroid (TSH suppressed)

4. Autoantibodies

5. Serum calcium, PTH, calcitonin (FHx medullary ca)

6. USS

7. FNA >1cm

4

USS features which may suggest Ca

1. Microcalcifications

2. Absence of vascular halo

3. Irregular margins

4. Taller than wide shape

5. Hypoechoic

6. Increased vascularity

5

Bathesda criteria and management

1. Non diagnostic->repeat FNA

2. Benign->clinical F/U

3. Atypia of undetermined significance or follicular lesion of undetermined significance->repeat FNA

4. Follicular neoplasm or suspicious for follicular neoplasm->Surgical lobectomy

5. Suspicious for malignancy->near total thyroidectomy or surgical lobectomy

6. Malignancy-> near-total thyroidectomy

6

Surgical management algorithm

Includes