Group 10

NECK MODULE
GENERAL DATA

V.H., 54 year old female

from Las Pinas City
CHIEF COMPLAINT

Anterior neck mass

History of Present Illness
3 months prior to
consult patient 1 month prior to
noticed mass on consult patient
the anterior neck. symptoms were
No associated persistent, opted
signs and to seek consult
symptoms were where thyroid
noted such as function tests and
tremor, ultrasound were
palpitation, requested and
nervousness, subsequently
edema, difficulty FNAB was done.
of breathing and Hence referred to
dysphagia. tumor clinic.
Past medical history

No diabetes mellitus, hypertension,

past surgery, bronchial asthma
Family History

No diabetes mellitus, hypertension,

bronchial asthma, pulmonary tuberculosis
Personal and social history

No alcohol

No cigarette intake
Physical Examination

Otoscopic Findings: Patent external auditory canal,

intact tympanic membrane. No tragal tenderness.

Anterior rhinoscopy: No evident obstruction of

turbinates, no secretions. Septum not deviated
Oral Cavity: No tonsillopharyngeal
congestion, no mass at floor of the
mouth

Anterior neck: 4x4 cm mass, moves with

deglutition, non-tender, well -
circumscribed

Lateral neck: No cervical

lymphadenopathies noted
1.What else would you like to ask in the history?
• Is swelling is associated with pain or not?
• What did you prefer hot or cold?
• Which salt did you use iodized or non iodized?
• Is there any aggravating factors?
• Is there any relieving factors?
• Do you have any trouble with eating, talking or swallowing?
• Have you lost weight?
• Is there any family or personal history of thyroid disease?
• Are you taking any medication?
2. What are the salient points in the case?
• Age(54)
• Female
• 3 months prior to consult patient noticed mass on the anterior neck
• 1 month prior to consult patient symptoms were persistent
• No diabetes mellitus, hypertension, past surgery, bronchial asthma
• No alcohol or cigarette intake
• Otoscopic findings: Patent external auditory canal, intact tympanic membrane, no tragal tenderness
• Anterior rhinoscopy: No evident obstruction of turbinates, no secretion, septum not deviated
• Oral cavity: No tonsillopharyngeal congestion, no mass at floor of the mass
• Anterior neck: 4*4 cm mass, moves with deglutition, on-tender, well-circumscribed
• Lateral neck: No cervical lymphadenopathies noted
3. What diagnostic test will your request for your
patient

The various diagnostic test for the the patient include:

• Complete physical examination.

• Blood test.
• Thyroid function test.
• Ultrasound.
• CT with contrast
• FNAB
4.PRIMARY WORKING IMPRESSION

• The primary working impression is thyroglossal duct cyst.

• Thyroglossal tract connect with tounge, It moves with tounge
movement.
• There is no risk factor presents for cancer.
• No smoking and no alcohol intake.
• There is no lymphadenopathy present.
.

• The thyroid function test is normal.

• There is no abnormal finding in otoscope examination.
• There is no abnormal finding in anterior rhinoscopy.
• Oral cavity findings are also normal.
• The Presented mass is well circumscribed, non tender.
 5. Differential diagnosis
• Solitary thyroid nodule
Rule in Rule out

Anterior neck mass (-) Dysphagia

Female(4 times more common than men) (-) Dyspnea

Well circumscribed (-) Nervousness

• Thyroid carcinoma

Rule in Rule out

Size of mass(4*4cm) (-)Dysphagia

Non tender to palpation (-)Hoarseness

Age(54) (-)Hard and fixed nodules

(-)Lymphadenopathy
 6. When is surgery warranted?
Treatment of a thyroglossal duct cyst

Specific treatment of a thyroglossal duct cyst will be determined based on:

● Age, overall health, and medical history

● Extent of the condition

Treatment may include:

● Antibiotic medication:infected thyroglossal duct cysts, require immediate antibiotic treatment. The
infection should be resolved before surgery is performed.

● It is well documented that the removal of a thyroglossal duct cyst before it becomes infected results in a
better outcome than if the cyst is removed after previous infection.
Surgical Removal

● To prevent recurrent infections due to the small risk of malignancy.

● Simple excision of thyroglossal duct cysts is associated with high recurrence rates (45% to 55%).
● The Sistrunk operation is considered the standard of surgical management and has dramatically
reduced recurrence rates.
○ requires a more extensive surgical resection including the central third of the hyoid bone and a
core of base of tongue tissue.
● Recurrence rates after a Sistrunk procedure are low, but patients should be monitored to ensure the
lesion does not return.
 7. WHAT ARE RISK FACTORS FOR
THYROID CANCER

Female sex - Thyroid cancer occurs more often in women than in men

Family history - Having a first-degree relative with thyroid cancer, even without a known inherited syndrome in
the family, increases your risk of thyroid cancer

Radiation exposure is a proven risk factor for thyroid cancer. Sources of such radiation include certain medical
treatments and radiation fallout from power plant accidents or nuclear weapons.

Iodine in the diet- Follicular thyroid cancers are more common in areas of the world where people’s diets are low in
iodine. On the other hand, a diet high in iodine may increase the risk of papillary thyroid canc er
8. Difference between Hyperthyroidism
and Hypothyroidism
 • NAGPURE,AISHWARYA
• RANA,PRASHANT SINGH
• RAVI,LOGESH
• SARAVANAN, NITHISH SURIYA
• SONAWANE, ABHIRAJPOPAT
• -,PRIYANSHI

GROUP • ZOBIAKMUANI
• -, VYSHNAV JAYAPRAKASH

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• ANTONY JOHN BENEDICT, TONY FELIX
• ARUMUGAM PILLAI GOMATHY PRATHABAN
• AVASTHI, LAXMI HARI
• AVASTHI, SHREE HARI
• AYIRAM , RAMANUJAM
• CHAUDHARY, ALOK
• CROSS EBENEZAR RUSKIN, JEFFERSON  RUSKIN
• DAVID ANTONYRAJ, RESHMA CAROLINE
• DURAISWAMY SHEELA, SHARKURU MONI
• JOSHI, RITESH