Clinical Case Database / Category: Case Based Discussion

Management of a thyroid nodule

Publication details

Sandeep Mistry MBChB BSc(hons)
Foundation Years Journal, volume 2, issue 7, p.313 (123Doc Education, London, September 2008)


A 56-year-old non-smoker presented with a 2-year history of a swelling in the front of the lower part of her neck. The swelling was of an insidious onset with no significant increase in size and there was no associated discomfort reported. However, occasional pressure symptoms were noted as well as a “feeling of something” in her throat. There had been no weight loss recorded. On examination, she was found to have a 4×3 cm swelling which seemed to be localised to the isthmus and adjacent part of the left thyroid lobe. This classically moved upwards upon swallowing. There was no associated lymphadenopathy. Initial clinical evaluation suggested the swelling to be a thyroid nodule.

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Sandeep Mistry MBChB BSc(hons) (Corresponding author)

Foundation Year 2 in Otolaryngology
North Manchester General Hospital
M8 5RB
United Kingdom


1. British Thyroid Association, Royal College of Physicians. Guidelines for the management of thyroid cancer (Perros P, ed) 2nd edn. Report of the Thyroid Cancer Guidelines Update Group. London: Royal College of Physicians, 2007.
2. Dankle SK. Thyroid nodule, 2007, Available at URL Accessed 29 August 2008.
3. National Institute of Clinical Excellence. Guidance on cancer services: Improving outcomes in head and neck cancers – the manual. NICE, 2004, Available at URL Accessed 24 August 2008.
4. Draper MR, Pfleiderer AG, Smith W. Assessment of a cytology grading system for head and neck masses. Clin. Otolaryngol, 2003, 28:34–38.
5. Feld S, Garcia M. AACE/AME Guidelines: American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. American Association of Clinical Endocrinologists, Available at URL Accessed 24 August 2008.
6. Hebra A, Miller M. Solitary thyroid nodule. 2006, Available at URL Accessed 29 August 2008.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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