History A 40-year-old woman has been referred to the surgical outpatients with a painless lump in the neck. She had noticed the lump 2 weeks previously when looking in the mirror. She had not noticed any other lumps and any other symptoms. Neither she gained nor lost any weight recently. Her bowel habit has remained normal. Examination Examination reveals a solitary 2 X 2 cm swelling to the left of the midline just above the manubrium.
The swelling is firm, smooth and fixed. The swelling moves on swallowing, but does not move on protrusion of the tongue. There are no associated palpable lymph glands. General examination reveals no further abnormalities. Laboratory Investigations Haemoglobin 12.0 g/dL Mean cell volume 77 fL White cell count 10.4 x 10 9 /L Platelets 250 x 10 9 /L Sodium 137 mmol/L Potassium 3.7 mmol/L Urea 5 mmol/L Creatinine 71 μmol/L Thyroid-stimulating hormone…
