Neck Mass, Goiter, Thyroid Disease - 63
The majority of neck masses are benign, but it is important to distinguish those rare ones which are malignant.
- Congenital (e.g., thyroglossal duct cyst)
- Inflammatory (e.g., reactive lymph nodes)
- Neoplasms (e.g., lipomas)
- Non-thyroid head and neck cancers
Given a patient with a neck mass, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan. Particular attention should be paid to excluding malignancy.
Given a patient with a neck mass, the candidate will
- list and interpret critical clinical findings, including
- an appropriate history and physical examination, paying particular attention to;
- risk factors predisposing to malignancy (e.g., smoking);
- time course;
- presence of pain, swallowing or systemic symptoms;
- signs or symptoms of thyroid dysfunction;
- list and interpret critical investigations, including
- recognition that no investigation may be necessary;
- investigation of thyroid function;
- diagnostic imaging;
- construct an effective initial management plan, including
- reassurance and appropriate follow-up for a suspected benign lesion;
- appropriate medical management (e.g., thyroid supplementation, antibiotics;
- referral for specialized care (e.g., fine needle aspiration), if necessary.