Thyroid nodule

A 55-years-old male was admitted to the hospital with a past medical history of nontoxic uninodular goitre, hypothyroidism, referred from primary care for a thyroid nodule found on neck ultrasound. He had dysphonia and dysphagia and was clinically and biochemically euthyroid.

 

Examination

The thyroid ultrasound showed right thyroid lobe measures 4.9×2.0×3.2 cm3 and the left thyroid lobe measures 3.1×0.7×1.0 cm3. A right lobe nodule at mid to lower pole, 3.1×1.8×3.2 cm3, cystic, hypoechoic with punctate echogenic foci, and smooth margins (Figure 1). Fine needle aspiration of the right thyroid lobe was performed, and the cytology reported sheets of squamous in a background of necrotic and proteinaceous material, consistent with an epidermal cyst. The patient underwent a right lobectomy. The gross section demonstrated a cyst with a solid and cystic area containing tan-brown cheesy material.