Last reviewed: June 2020
Last updated: March  2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • palpable thyroid nodule

Other diagnostic factors

  • early adulthood
  • family history of thyroid cancer
  • hoarseness
  • dyspnoea
  • dysphagia
  • tracheal deviation
  • cervical lymphadenopathy
  • rapid neck enlargement

Risk factors

  • head and neck irradiation
  • female sex
  • family history of thyroid cancer

Diagnostic investigations

1st investigations to order

  • TSH
  • ultrasound, neck
  • fine-needle biopsy
  • laryngoscopy
More 1st investigations to order

Investigations to consider

  • free T4
  • free T3
  • I-123 thyroid scan and uptake
  • core biopsy
  • CT, neck
  • serum calcitonin
  • genetic testing for familial syndromes
More investigations to consider

Emerging tests

  • ultrasound elastography
  • molecular analysis of cytology specimens
  • sentinel node biopsy
More emerging tests

Treatment algorithm

Contributors

Rajiv Datta

Chairman

Department of Surgery

Chief

Division of Surgical Oncology

Chief

Division of Head and Neck Surgery

South Nassau Hospital

Valley Stream

NY

Disclosures

RD declares that he has no competing interests.

Peer reviewersVIEW ALL

Professor of Surgery

Cornell University Medical College

Attending Surgeon

Memorial Sloan-Kettering Cancer Center

New York

NY

Disclosures

ARS declares that he has no competing interests.

Consultant Endocrine Surgeon

Hammersmith & Charing Cross Hospitals

Clinical Lead for Endocrine Surgery

Honorary Senior Lecturer

Imperial College

London

UK

Disclosures

FFP declares that he has no competing interests.

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