A 60 year old woman presents with a painless neck lump for 3 months.

There was no history of recent rapid enlargement, voice changes or discomfort in swallowing.

Her medical history is unremarkable and she is not on any medications.

Select Relevant Investigations
Ultrasound of Lump


The lump appears to be a hyperechoic upper jugulodigastric node 4.1 x 3.2 cm in size, with a sharp border, peripheral vascularity and punctate calcification, but no intranodal necrosis. No other enlarged lymph nodes are seen.
Ultrasound Thyroid


The superior pole of the right lobe contains a solid, ill-defined, hypoechoic nodule 8 mm in diameter, with punctate calcifications.
Imaging guided FNAC


Cytology of the lump: suggestive of nodal metastasis of papillary thyroid cancer

Cytology of the thyroid nodule: Thy 5 category (definitely malignant)
Serum Thyroglobulin


The serum thyroglobulin level is 10 ng/ml (normal: ≤ 33)

Select Relevant Management
Total Thyroidectomy
B/L Radical Block Dissection
External Beam Radiotherapy