Assessment of a thyroid mass Flashcards Preview

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...

1. Complete thyroid examination

2. Hyper/hypothyroid

3. Listen for dysphonia, dyspnea

4. Evidence of other malignancy

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

1. Microcalcifications

2. Absence of vascular halo

3. Irregular margins

4. Taller than wide shape

5. Hypoechoic

6. Increased vascularity

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

Includes