[Follicular Thyroid Carcinoma Detected by Cervical Palpation in a Young Patient-A Case Report]

The patient was a male in his twenties. During the physical examination, a 40-mm mass was palpated in the right lobe of the thyroid gland. Ultrasonography revealed a 42-mm hypoechoic mass with a heterogeneous internal echotexture and a peripheral hypoechoic rim with abundant vascularity in the right thyroid lobe. The CT and MRI findings were a benign mass. Laboratory test results, including thyroid function test results, were within normal limits. Fine-needle aspiration cytology suggested the presence of a follicular neoplasm. Right lobectomy was performed. The pathological diagnosis was encapsulated follicular carcinoma with vascular invasion: pT3a, pNx, pEX0, vascular invasion(positive, multiple), stage Ⅰ, and a high risk of recurrence. The incidence of thyroid cancer is 1.4-2.3 per 100,000 for males and 6.5-10.7 per 100,000 for females in their twenties. Currently, there are no established guidelines for cervical palpation during medical checkups, and physical examinations are performed at the physician's discretion. In this case, the patient could have been cured with local therapy alone if neck palpation had been performed during an earlier examination. The malignancy rate of palpable thyroid nodules is approximately 10%. Cervical palpation remains a valuable screening tool owing to its simplicity and noninvasiveness.