STATION 2 ANSWERS

A 40-year-old woman presents with a neck mass.

1.    What is your diagnosis? What are the reasons for your diagnosis?

Thyroid follicular adenoma. 

It is a solitary nodule well demarcated from the adjacent parenchyma by a well-defined fibrous capsule. 

2.    What pre-op procedures are needed?

Fine needle aspiration biopsy is frequently used to evaluate the suspected adenomas before surgical excision.

3.    What are the clinical manifestations?

a.    The patient is euthyroid.

b.    The nodule is palpable and visible, smooth, usually firm and not hard, painless and moves freely on swallowing.

4.    Why does the patient complain of sudden pain and swelling?

It is due to hemorrhage into the adenoma. However, suspicion of a carcinoma should be raised.

Copyright � Joseph Ong 2003