Patient has a large mass in the lateral neck with normal thyroid examination and ultrasound.
Bulging mass in the lateral right neck.
FNA was negative for cells, but the needle washout for thyroglobulin was very positive at 11,049. N <1.
The treatment included removal of the cyst which was positive for papillary carcinoma metastatic in a lymph node.
Total thyroid removal found multifocal micro-papillary thyroid cancer.
Neck dissection was positive in 4/26 lymph nodes.
Thyrogobulin needle washout made he diagnosis where the cytology was not helpful.