Anterior neck swelling - Malignancy?

Chief Complaint A 66 y/o female came with the swelling over the anterior neck, tiredness & weakness. History He has h/o surgery for esophageal adenocarcinoma then chemotherapy & radiotherapy. Vitals BP: 130/85 mmhg, Pulse: 76 bpm, Resp rate: 20 bpm, Temp: 98.2 degree F. Examination It shows a hard goiter. Enlarged firm and non-movable cervical lymph nodes were also noted. Lab shows TSH levels 55 mIU/l, decreased free T4 and T3 and increased anti-thyroid antibodies. Treatment What is your opinion on diagnosis and treatment?

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Ske is Hypothyroid...With Hashimoto Thyroiditis. But hardness of lymph node is a warning singnel for Secondary drain of previous malignancy One possibility of Adeno carcinoma of esophagus Biopsy would be conclusive. Though Oncosurgeion is an authantic person for intervention.

Known c/o adenocarcinoma oesophagus Present with swelling over anterior neck hard nonmovable cervical lymphadenopathy are secondaries metastasis High tsh suggest hypothyroidism also increased anti TPO likely hashimoto's Needs to r/o malignant thyroid

Hard lymph nodes suggest metastasis in a known case if adenocarcinoma of oesophagus High TSH indicate hypothyroidism, which need to be treated with thyroid hormone supplement

Need to ruleout secondary metastasis.. Levo Thyroxin to be started. Thyroid scan may be helpful for deciding further treatment options

High TSH indicate Hypothyroidism start with Thyroxin supplement as per Body weight. Do CECT Neck for conclusion

Lymphoma

Hashimotos thyroiditis?

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