Endocrine Abstracts

A 49-year old female scrub nurse was referred to the Thyroid MDT having noted a palpable lump over her neck after opting to examine herself following a thyroidectomy case in theatre. US thyroid revealed several nodules with both lobes of the thyroid, of varying sizes; the largest was in the L lobe, measured 35mm × 27mm and was iso-hyperechoic, with areas of central necrosis, consistent with a U3 classification. She was clinically and biochemically euthyroid. FNA was subsequently performed, with cytology confirming a Thy3F lesion. The case was discussed at MDT and she was offered a hemithyroidectomy, which was later performed and confirmed the diagnosis of follicular carcinoma, staging pT2 N0 R0. Her case was re-discussed at MDT, with a plan agreed for completion right hemithyroidectomy, which showed a 30mm widely invasive follicular carcinoma, staging pT2 N0 R1 (vascular invasion, positive margin). The case was discussed at MDT once more, with a plan agreed for radio-iodine ablation. She remains euthyroid on appropriate thyroid hormone replacement, and will remain under dynamic risk assessment going forwards. Clinical self-examination has proven to be an effective tool in improving early detection of breast and testicular cancers, aided by promotional tools and campaigns which have encouraged uptake of this among the general public. This case highlights the importance of self-examination in other contexts, and extending the application of this in helping improve early detection of head and neck cancers as well.