Long-Term Management of Thyroid Cancer

E. Chester Ridgway, MD
Professor of Medicine
Head, Division of Endocrinology, Metabolism and Diabetes
University of Colorado Health Sciences Center
Denver, Colorado

Initial Presentation

A 32-year-old woman presents with a thyroid nodule. She has no history of head or neck irradiation, and no symptoms of hypothyroidism or hyperthyroidism. She is an opera singer and is concerned about preservation of her voice. Although she denies dysphagia, she admits to having a “raspy voice.”

On examination, she is an obese African American whose blood pressure is 136/90 mm Hg and pulse is 78 beats per minute. There is a 2.5-cm firm nodule in the left lobe of the thyroid, which is nonfixated and moves easily with swallowing. There is no associated lymphadenopathy in the anterior cervical lymph node chain or in the supraclavicular fossa.

A fine needle aspiration biopsy reveals papillary thyroid carcinoma, and the patient undergoes thyroid surgery.