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Papillary thyroid cancer — SCE Endocrinology MCQ

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ModerateThyroidPapillary thyroid cancerSCE Endocrinology

A 52-year-old woman has a 2.4 cm thyroid nodule. Ultrasound shows irregular margins, microcalcifications and taller-than-wide shape. Fine-needle aspiration cytology is Thy5. TSH is normal and there is no vocal-cord palsy. What is the most appropriate management?

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Correct answer: D — Refer for thyroid cancer surgery through the thyroid MDT

Thy5 cytology in a suspicious nodule requires thyroid cancer MDT management and surgical planning. Levothyroxine suppression is not appropriate primary treatment for a malignant cytology nodule. The pearl is that euthyroid status does not make a suspicious structural nodule benign.

Reference: NICE NG230, British Thyroid Association guidance