A 50 years old woman with two subcutaneous neck nodules

    A 50 years old woman presented with two subcutaneous neck nodules. Thyroidectomy was performed 4 years ago and medullary carcinoma of the thyroid identified. Immunohistochemistry at the time reveals reactivity for calcitonin but not thyroglobulin. Three years after that, radical neck dissection performed and recurrence of medullary carcinoma with nine reactive lymph nodes identified. One year after surgery, re-excision of the lesion reveals metastasis of the medularry carcinoma to subcutaneous tissue and one lymph node. Now she is presented with two right side subcutaneous neck nodules.