Case 261 -- A Left Thyroid Mass

Contributed by Raj Hari, MD
Published on line in March 2001


The patient is a 66-year-old gentleman who presented with a left thyroid mass. The patient was evaluated at an outside facility, and a fine needle aspirate was done which revealed suspicious cells for papillary carcinoma. The patient had a palpable prominent left thyroid area mass but also had prominent lymphadenopathy. The patient underwent an MRI scan which indeed revealed a large thyroid mass. In addition, there was a large zone II mass which was compressing the internal jugular vein. There also appeared to be lymphadenopathy in the jugular chain in zones III and IV.


The specimen was received fresh, appropriately identified and was labeled "left thyroid lobe". The specimen consisted of thyroid weighing 42.34 grams and measuring 6.1 x 5.2 x 2.0 cm. The specimen is unoriented, no suture or stitch is noted. The external surface appears shiny, gray-maroon with attached perithyroidal fat. There is no evidence of gross extension of tumor outside the thyroid capsule. On cut section, there is a 4.5 cm poorly circumscribed, tan-white, indurated lesion with infiltrating borders and foci of hemorrhage and necrosis. The rest of the thyroid is orange-yellow, fleshy with no evidence of nodules noted. The external surface was inked in black.



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