A 35-year-old man presents to his physician with a small mass that he found in the anterior part of his neck a few days ago. The mass is not painful and does not affect his swallowing. He has noticed no change in his weight. His history is significant for radiotherapy for neuroblastoma at the age of 15 years. On examination, a nodule around the size of 2.2 cm is palpated in the right thyroid lobule: the nodule is firm and non-tender. There is cervical lymphadenopathy. His blood pressure is 118/75 mm Hg, respirations are 17/min, pulse is 67/min, and temperature is 37.5°C (99.5-F). Laboratory findings include: serum Na+ 136 mmol/L. K+ 4.2 mmol/L. CI-90 mmol/L, and bicarbonate 24 mmol/L. Which of the following factors will most likely make the prognosis worse in this patient?
Select one:
a. Age
b. Bone metastases
c. Hurthle cell variant
d. Palpable lymph nodes
e. Follicular histological variant
Diagnosis is most likely papillary thyroid cancer.
Follicular variant i.e. lindsay tumor has a poorer prognosis as it metastasises more; so that may be the answer.
History of Radiation Exposure and Clinically Palpable LN makes it most probably a Neoplastic Thyroid Lesion…? PTC
If we take the prognostic Criteria For Thyroid Ca ( Ages/Ames/macis etc) all of the options are included …
But most importantly its AGE of the patient(here its less ).
So my next best answer would be Metastasis
So I prefer Option B
in this case ?? Age is 35
Ohh i didn’t see that…Then Metastatis B
Of course metastasis