Last reviewed: 22 Aug 2021
Last updated: 04 Mar 2020
Summary
Definition
History and exam
Key diagnostic factors
- palpable thyroid nodule
- female sex
- history of head and neck irradiation
Other diagnostic factors
- early adulthood
- family history of thyroid cancer
- hoarseness
- dyspnea
- dysphagia
- tracheal deviation
- cervical lymphadenopathy
- rapid neck enlargement
Diagnostic investigations
1st investigations to order
- TSH
- ultrasound, neck
- fine-needle biopsy
- laryngoscopy
Investigations to consider
- free T4
- free T3
- I-123 thyroid scan and uptake
- core biopsy
- CT, neck
- serum calcitonin
- genetic testing for familial syndromes
Emerging tests
- ultrasound elastography
- molecular analysis of cytology specimens
- sentinel node biopsy
Treatment algorithm
Contributors
Authors
Rajiv Datta, MD, FACS, FRCS, FICS
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 reviewers
Ashok R. Shaha, MD, FACS
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.
F. Fausto Palazzo, MS, FRCS
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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