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Papillary thyroid carcinoma with nodal disease — SCE Endocrinology MCQ

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HardThyroidPapillary thyroid carcinoma with nodal diseaseSCE Endocrinology

A 63-year-old woman has persistent hoarseness and a 3 cm hard thyroid nodule. Ultrasound shows extrathyroidal extension and abnormal lateral cervical nodes. Fine-needle aspiration suggests papillary thyroid carcinoma. What is the most appropriate next investigation?

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Correct answer: A — Ultrasound-guided cytology of suspicious cervical lymph nodes

Suspicious cervical nodes should be sampled preoperatively because nodal status changes surgical planning. Radioiodine is not given before appropriate surgery and staging. The pearl is that thyroid cancer assessment is structural and MDT-led.

Reference: NICE NG230, British Thyroid Association guidance