An 85-year-old woman was referred with a lump in her neck. She had no symptoms of thyroid disease.
On examination, she had a 2 ? 3-cm firm mass at the lower pole in the right thyroid lobe.
Her resting pulse was 90 beats per minute and regular.
Investigations:
serum thyroid-stimulating hormone3.5 mU/L (0.4C5.0)
serum free T415.0 pmol/L (10.0C22.0)
serum free T36.2 pmol/L (3.0C7.0)
anti-thyroid peroxidase antibodies28 IU/mL (<50)
ultrasound scan of thyroidmixed cystic/solid mass with
scattered microcalcifications
fine-needle aspiration biopsyThy 3a
What is the most appropriate next step in her management?
A . ablative radioiodine treatment
B . CT scan of neck
C . PET scan of thyroid
D . repeat fine-needle aspiration
E . subtotal thyroidectomy
Answer: D