It emerges under the anterior border of the sternocleidomastoid muscle where the upper 1/3 meets the lower 2/3.
Investigation: US and FNAC.
Treatment: surgical removal.
CAROTID BODY TUMOUR
Located in anterior triangle.
It moves side to side but not up and down.
It may be pulsatile.
It usually does not cause bruit.
It is located just anterior to the upper 1/3 of sternocleidomastoid muscle.
Investigation: Doppler USS and arteriography.
Treatment: Surgical extirpation.
Located in the anterior triangle at the upper posterior region at the angle of the jaw.
Usually patient age >40 years
Investigation: USS, mump test will be negative.
Trans-illuminating mid-line lump which moves on tongue protrusion.
Treatment: Surgical removal.
Mid-line lump which moves on swallowing but not on tongue protrusion.
All patients with thyroid nodules must have TSH measurement .
If low, then measure T4 & T3.
USS recommended in patients with atypical solitary nodules and multiple goiter:
– If it is a CYST then treatment is surgical removal
-If it’s solid then FNAC (It is recommended in all patients with solitary nodules)
Pre- existing goiter
Radiation of neck in childhood
Types including Frequency and Clinical features:
Papillary (60%) : Solitary thyroid nodule
Follicular (25%) : Slow growing thyroid mass, symptoms are usually from distant metastases.
Anaplastic (10%) : Rapidly growing thyroid mass causing tracheal and oesophageal compression.
Medullary (5%) : Thyroid lump, may have MEN II A ( medullary carcinoma, pheochromocytoma, hyperparathyroidism) or MEN II B (medullary thyroid carcinoma, pheochromocytoma, multiple mucosal neuromas, Marfanoid habitus ) syndrome.
-Surgery: total thyroidectomy & removal of involved lymphnodes