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Wk 8, Case 3 - Review

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Report

Patient History
Right thyroid mass.

Findings
Contrast-enhanced CT was performed from the skull base to the thoracic inlet. Study shows no evidence of aggressive lesions involving the nasopharynx, oral cavity, tongue base, tonsils, larynx or hypopharynx. No evidence of enlarged lymph nodes using standard size criteria.

There is a dominant mass involving the right lobe of the thyroid gland which measures approximately 3.5cm in largest dimension. This mass is associated with multiple punctate and peripheral and central calcifications. The mass abuts the lateral wall of the trachea without obvious evidence of tracheal invasion. The right-sided thyroid mass results in medial deviation of the common carotid artery which extends into the right tracheoesophageal groove. There is no evidence of carotid artery encasement.

There is heterogeneity of the left lobe of the thyroid gland with a small low-attenuation mass and measures approximately 5mm.

Visualized portion of the brain is grossly within normal limits.] However, dedicated brain imaging is necessary for complete diagnostic evaluation.

Parenchymal changes involving the bilateral lung apices. However, dedicated chest CT is necessary for complete diagnostic evaluation.

Conclusions
A 3.5cm dominant mass involving the right lobe of the thyroid gland. This may represent a large partially calcified thyroid adenoma. However, a thyroid neoplasm such as either papillary thyroid carcinoma or medullary thyroid carcinoma must also be considered.

Case Discussion

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Suresh K Mukherji, MD, FACR, MBA

Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging

Tags

Neuroradiology

Head and Neck

CT

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