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    Thyroid Nodule

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    Jameson87
    A 32-year-old male presents with a symptomatic 3cm thyroid nodule. Ultrasound and biopsy found it to be benign. Removal of the left thyroid lobe and connecting tissue is recommended to relieve symptoms despite the low risk of malignancy. A 48-year-old female has a biopsy-confirmed papillary carcinoma in her thyroid. Evaluation of her vocal cord function with laryngoscopy is the next step before deciding between lobe removal or total thyroidectomy. A 50-year-old woman had thyroid cancer treated with surgery and radiation. Annual measurement of thyroglobulin, a marker of thyroid cells, is most appropriate for long-term surveillance, along with monitoring of her thyroid stimulating

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    Thyroid Nodule

    Uploaded by

    Jameson87
    207 views2 pages
    A 32-year-old male presents with a symptomatic 3cm thyroid nodule. Ultrasound and biopsy found it to be benign. Removal of the left thyroid lobe and connecting tissue is recommended to relieve symptoms despite the low risk of malignancy. A 48-year-old female has a biopsy-confirmed papillary carcinoma in her thyroid. Evaluation of her vocal cord function with laryngoscopy is the next step before deciding between lobe removal or total thyroidectomy. A 50-year-old woman had thyroid cancer treated with surgery and radiation. Annual measurement of thyroglobulin, a marker of thyroid cells, is most appropriate for long-term surveillance, along with monitoring of her thyroid stimulating

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    Surgery- thyroid management

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    A 32-year-old male presents with a symptomatic 3cm thyroid nodule. Ultrasound and biopsy found it to be benign. Removal of the left thyroid lobe and connecting tissue is recommended to relieve symptoms despite the low risk of malignancy. A 48-year-old female has a biopsy-confirmed papillary carcinoma in her thyroid. Evaluation of her vocal cord function with laryngoscopy is the next step before deciding between lobe removal or total thyroidectomy. A 50-year-old woman had thyroid cancer treated with surgery and radiation. Annual measurement of thyroglobulin, a marker of thyroid cells, is most appropriate for long-term surveillance, along with monitoring of her thyroid stimulating

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    207 views2 pages

    Thyroid Nodule

    Uploaded by

    Jameson87
    A 32-year-old male presents with a symptomatic 3cm thyroid nodule. Ultrasound and biopsy found it to be benign. Removal of the left thyroid lobe and connecting tissue is recommended to relieve symptoms despite the low risk of malignancy. A 48-year-old female has a biopsy-confirmed papillary carcinoma in her thyroid. Evaluation of her vocal cord function with laryngoscopy is the next step before deciding between lobe removal or total thyroidectomy. A 50-year-old woman had thyroid cancer treated with surgery and radiation. Annual measurement of thyroglobulin, a marker of thyroid cells, is most appropriate for long-term surveillance, along with monitoring of her thyroid stimulating

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 2

    ThyroidNodule

    1)A32yearoldmalepresentswitha3cmleftthyroidnodule.Hereportscervicaldysphagia.TSHlevels
    arenormal.USrevealsbenigncharacteristicsandnootherthyroidnodules.USguidedFNArevealsa
    BethesdaCategoryIIbenignnodule.Whatisthenextmostappropriatestepinmanagement?
    Subtotalthyroidectomy
    Leftthyroidlobectomyandisthmusectomy
    CTscanoftheneck
    Refertoendocrinologyforradioactiveiodineablation
    Referpatientbacktoprimarycareforroutinefollowup
    Youransweriscorrect
    Discussion:Thispatientpresentswithasymptomaticthyroidnodulecausingdysphagia.AlthoughhisFNA
    revealsalowrisknoduleformalignancy(03%basedonBethesdacriteria),thenoduleisstillcausing
    troubleswallowing.Inaeuthyroidsetting,radioactiveablationisnotindicated.CTscanoftheneckwould
    notprovideanyadditionalinformationinthedecisionmakingprocess.Intheabsenceofmultinodular
    goiter,aunilateralprocedureispreferred.

    2)A48yearoldfemaleundergoesevaluationforhoarseness.Herworkuprevealsa4.2cmrightthyroid
    nodule.SubsequentUSguidedFNArevealsaBethesdaCategoryVInodule,consistentwithpapillary
    carcinoma.Whatisthenextmostappropriatestepinhermanagement?
    MRIoftheneck
    Nuclearmedicinethyroidscan
    Laryngoscopy
    Rightthyroidlobectomyandisthmusectomy
    Totalthyroidectomy
    Youranswerisnotcorrect
    Discussion:Inpatientswiththyroidcancerwhopresentwithsignsofinvasionintoadjacentstructures,
    laryngoscopyshouldbeperformedtoevaluatethefunctionofthevocalcordspreoperatively.Anuclear
    medicinethyroidscanwouldnotchangemanagementatthispointinherevaluation,norwouldMRI.A
    totalthyroidectomywouldbethedefinitiveprocedureofchoiceafterlaryngoscopytoevaluatehervocal
    cords.Althoughlobectomyandisthmusectomyisanappropriatedefinitiveprocedureforsomethyroid
    cancers,thispatient'sageandsizeoftumormakeitaninferioroperationinthissetting.

    3)A50yearoldfemaleundergoesatotalthyroidectomyforpapillarythyroidcarcinoma.Tumorsizeis
    3cmandtherewerenoinvolvedlymphnodes.Postoperativelysheundergoesradioactiveiodineremnant
    ablation.Whichofthefollowingisappropriatelongtermfollowupcareforthyroidcancersurveillance?
    AnnualTSHmeasurement
    AnnualCTscanofthechest
    AnnualI131scan
    Annualthyroglobulinmeasurement

    AnnualCTscanoftheneck
    Youranswerisnotcorrect
    Discussion:Thyroglobulinisonlyproducedbythyroidcellsandisanexcellentclinicalindicatorof
    recurrence.InthesettingofTSHsuppression,aclimbingthyroglobulinlevelshouldpromptfurther
    investigationofapossiblerecurrence.TSHlevelsshouldbemonitoredmorefrequentlythanannuallyto
    maintainTSHsuppression.CTscansoftheneckorchestarenotindicatedforroutinesurveillance.I 131
    scanningcanbeusefulforfurtherevaluationifarecurrenceissuspected.

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