Sandbox:DDx HEENT

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  • 65 yo women
  • Rapidly enlarging neck mass
  • Neck pain, dyspnea, dysphagia, and hoarseness
  • Constitutional symptoms
  • Tender hard nodular goiter
  • Extensive lymphadenopathy
  • Painless thyroid nodule
  • Neck lymphadenopathy
  • Elevated calcitonin
  • Elevated chromogranin
  • Elevated CEA
  • Multiple hypoechoegenic lesions on U/s
  • Lymph node calcifications
  • Liver metastasis
  • Nested cellular pattern separated by delicate vascular septa
  • Polygonal cells, round nuclie with coarse chromatin, granular cytoplasm, surrounded by amyloid deposits
  • Vascular stroma with hemorrhage, edema, and coarse calcification
  • C-cell hyperplasia may be present


  • RET proto-oncogene
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