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June 1988

Resident's Page

Author Affiliations

SECTION EDITOR University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1988;114(6):684-687. doi:10.1001/archotol.1988.01860180098055

PATHOLOGIC QUIZ CASE 1  Michael F. Pratt, MD, Charleston, SCA 38-year-old woman presented with an asymptomatic mass on the right side of her neck detected by her gynecologist during a routine examination. The patient related a history of therapeutic right neck irradiation when she was 3 years old.Physical examination revealed a 4×3-cm right thyroid nodule. Head and neck examination was otherwise unremarkable. Fine-needle aspiration produced solid cellular material that was consistent with follicular neoplasm by microscopic examination. A technetium Tc 99m thyroid scan showed a nonfunctioning right thyroid mass. Ultrasound study showed a solid nodule in the right thyroid lobe. Results of in vitro thyroid function tests were normal.A right thyroid lobectomy with isthmusectomy was performed. Frozen section analysis was inconclusive. Gross examination of the surgical specimen revealed a 4.0×3.5×2.0-cm ovoid nodular lesion within the middle and superior pole. The tumor was not encapsulated. The mass was