Head & Neck Case Review 2020-11

Head & Neck Case Review

November, 2020

History

A 58-year-old woman presented to her physician with a chief concern of mass of her anterior neck, of several years’ duration.  She was also experiencing dysphagia and hoarseness.  Review of her medical history revealed no medical conditions or medications.  The patient had smoked cigarettes for many years.  The mass was firm to palpation.  It was centered in the thyroid gland and was fixed to underlying anatomic structures, per radiographic evaluation.  At the time of presentation, the patient was euthyroid.  A total thyroidectomy was performed, with suspicion for a malignant process.

Images

Quiz

Q1.

  1. Given the histologic findings, which additional laboratory test would be most beneficial in evaluation of this patient?
  • A. PTH
  • B. RET status
  • C. Serum IgG4
  • D. Serum thyroglobulin

Q2. What is the vascular alteration characteristic of this disease process?

  • A. Vasculitis
  • B. Superior vena cava syndrome
  • C. Thrombosis
  • D. Occlusive phlebitis

Diagnosis

Contributors

Anne C. McLean-Holden, DMD, MS: Emory University Hospital, Atlanta, GA

Justin A. Bishop, MD: University of Texas Southwestern Medical Center, Dallas, TX