Medullary Thyroid Carcinoma Presenting with Calcified Thyroid Nodule, Calcified Lung and Cervical Lymph Node Metastasis: A Case Report

Abstract

A 64-year-old male patient was admitted to the General Medicine ward for uncontrolled type 2 diabetes mellitus and peripheral vascular disease. On examination, there was presence of neck swelling on the right-side. The swelling was insidious in onset, initially small in size, and slowly progressed to its current size over the past five years. There was no associated pain. There was no history of fever, nausea, vomiting or difficulty in swallowing or breathing. There was also no history of loss of appetite, weight loss, or weight gain. On examination, the swelling moved with deglutition and was noted in the right lower neck in the region of thyroid gland. The approximate size of the swelling was 4×4 cm and the lower border of the swelling was visible. On palpation, the swelling was firm in consistency and partially mobile. There were palpable lymph nodes on the right-side of the neck in level IB and III regions. Clinically, a diagnosis of thyroid carcinoma was kept, in view of palpable lymph nodes. Blood investigations showed a reduced haemoglobin level of 10.4 g/dL. Rest of the investigations, including thyroid function tests were normal.

Keywords

• multiple endocrine neoplasia
• nodal metastasis
• thyroidectomy
• thyroid gland