No Palpable Cervical Lymphadenopathy in Surgery — 28yo Woman | General Surgery | SMLE Q#1194

SMLE Question #1194

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 28-year-old woman previously received external-beam neck radiation for Hodgkin lymphoma. She has 3 months of a gradually enlarging, painless left anterior neck mass. Examination shows a firm, non-tender 3–4 cm thyroid nodule with no palpable cervical lymphadenopathy. Thyroid ultrasound shows a 3 × 4 cm solid hypoechoic lesion with microcalcifications. Fine-needle aspiration confirms papillary thyroid carcinoma. Cross-sectional imaging shows no distant metastasis. What is the best definitive surgical management?

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