A 28-year-old woman complained of an asymptomatic, gradually enlarging neck mass, present for about 2 months. This was an incidental complaint voiced during a rosacea follow-up visit.
Key point: Physical examination revealed a firm, non-transilluminating (solid) mass located on the lower, anteromedial neck. Placement just below the thyroid cartilage suggested thyroid gland localization, which was verified by CT scan. Scintigraphy revealed a “cold” thyroid nodule. Fine-needle aspiration biopsy strongly suggested papillary thyroid carcinoma.
Treatment: The diagnosis of cancer was verified at the time of thyroidectomy. A regimen of thyroid hormone replacement was subsequently started.
Note: There are many etiologies of neck masses. Along with a detailed patient history, a CT scan, ultrasonogram, MRI scan, radionuclide scan, and fine-needle aspiration biopsy may help determine the precise cause. Appropriate therapy follows accurate diagnosis.