PAEA Surgery End Of Rotation (EOR) Practice Exam

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Which cancer type is associated with early lymph node metastasis?

Anaplastic
Follicular
Medullary
Papillary

The correct answer is: Medullary

Medullary thyroid carcinoma is characterized by its tendency to metastasize to lymph nodes at an earlier stage compared to other types of thyroid cancers. This type of cancer arises from parafollicular C cells that produce calcitonin. Due to this unique origin and biological behavior, medullary thyroid carcinoma often presents with lymph node involvement at diagnosis, which can indicate a more aggressive form of the disease. In contrast, other cancer types such as papillary thyroid carcinoma often have a more indolent course and may not spread to lymph nodes as quickly. Follicular thyroid carcinoma can metastasize, but typically not as early as medullary carcinoma. Anaplastic thyroid carcinoma is aggressive as well but usually presents at a much later stage with systemic disease rather than isolated early lymph node metastasis. This distinction is important for understanding the clinical behavior and management strategies for different thyroid cancers.