Neck mass that moves with swallowing

Abstract

A 53-year-old woman is referred to your clinic with a chief complaint of a neck mass. She sought care after feeling a lump in the lower anterior neck, just right of the midline. She complains of a sensation of neck tightness, especially when lying supine. She denies any voice changes, difficulty swallowing, or pain. She denies exposure to ionizing radiation. She takes no medications and has no known drug allergies. Her social history is negative for tobacco and alcohol use. She does not have a family history of neck tumors or thyroid problems. On physical exam, you find a well-nourished normal adult female with a solitary, 2-cm nodule in the right lobe of the thyroid that moves with swallowing. There is no associated cervical adenopathy. Her laboratory tests demonstrate a TSH of 2 mIU/L (normal 0.4-4) and normal serum free T4 and free T3 levels. An ultrasound confirms the presence of a roughly spherical, well-demarcated 2-cm nodule in the right lobe of the thyroid and normal cervical lymph nodes.