AUTHOR=Wan Qinyun , Sun Li , Gan Lu , Liu Jianxue 

TITLE=The role of ultrasound in diagnosing 2mm medullary thyroid carcinoma with cervical lymph node metastasis: a case report

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1588295

DOI=10.3389/fonc.2025.1588295

ISSN=2234-943X

ABSTRACT=BackgroundMedullary thyroid carcinoma (MTC) is a rare, aggressive thyroid cancer, comprising 5%-10% of cases, often leading to cervical lymph node metastasis.Case presentationWe report a 49-year-old woman with a 2 mm micro-nodule in the left thyroid lobe and two suspicious lymph nodes in the neck. Ultrasound-guided fine needle aspiration indicated MTC, confirmed by immunohistochemical analysis. Following total thyroidectomy and left cervical lymphadenectomy, two of 26 lymph nodes showed metastasis. The cancer was 2 mm, with no capsular invasion, and positive markers for MTC were noted. This case emphasizes the importance of early MTC detection in micro-nodules and thorough lymph node evaluation.ConclusionEven a 2 mm MTC has the potential to metastasize lateral cervical lymph nodes. This emphasizes the necessity of meticulous ultrasound evaluation by experienced clinicians to detect abnormal lymph nodes and inform clinical management. Interventional ultrasound plays a crucial role in both diagnosing MTC micro-nodules and identifying associated lymph node metastases.