
Ultrasonography of Thyroid
甲狀腺超聲波
Thyroid ultrasound is a non-invasive examination. Doctors use ultrasound imaging to examine whether there are any abnormal tumors, calcifications, and other conditions within the thyroid gland. It can also check for enlarged lymph nodes in the neck, providing important information for clinical diagnosis.
$ 1,000

Thyroid Function Test
甲狀腺功能檢查
The purpose of thyroid function testing is to evaluate the thyroid levels in a patient’s body. Conditions such as hyperthyroidism and hypothyroidism can be diagnosed through a simple blood test. The testing can also help doctors differentiate thyroid function problems caused by different factors.
Typically, thyroid function testing includes measuring the levels of thyroid hormone T4 and thyroid-stimulating hormone (TSH).
$ 600

Ultrasound-Guided Fine Needle Aspiration
超聲波導引幼針穿刺
If a suspicious thyroid tumor is detected during an ultrasound examination, the doctor may arrange for an ultrasound-guided fine-needle aspiration biopsy. This procedure involves extracting a small amount of cells from the suspicious thyroid tumor for pathological analysis. It helps determine whether the tumor is benign or malignant, as well as its nature or characteristics.
$ 2,800
Thyroid
About Thyroid Cancers
Thyroid cancer is one of the top ten common cancers in Hong Kong, ranking tenth. In 2017, there were a total of 884 cases, with a majority being females. Among them, there were 181 males and 703 females. The chances of females developing thyroid cancer are 3.8 times higher than males. Among young females, thyroid cancer ranks second in terms of cancer incidence, second only to breast cancer. Thyroid cancer most commonly occurs in individuals aged 35 to 65.
The majority of thyroid cancers belong to the papillary carcinoma type, and approximately 30-50% of patients are diagnosed with lymph node metastasis. Most cases are diagnosed without distant metastasis. The primary treatment for thyroid cancer is thyroidectomy, which may be accompanied by neck lymph node dissection, and radioactive iodine therapy may be used as an additional treatment depending on the situation.
Thyroid cancer originates from the mutation and proliferation of thyroid cells and can be classified into four types based on their characteristics: papillary carcinoma, follicular carcinoma, medullary carcinoma, and anaplastic carcinoma. Each type of cancer has distinct clinical features, growth rate, and prognosis.
Papillary Carcinoma
Papillary carcinoma is the most common type of thyroid cancer, accounting for approximately 70-80% of all cases. It predominantly occurs in children and adolescents (under 40 years old), with a higher incidence in females. This type of cancer generally grows slowly, and cancer cells can exist in the thyroid for several years. The cancer cells can spread to neck lymph nodes through lymphatic channels. Approximately 30-50% of patients are already diagnosed with neck lymph node metastasis. The primary treatment for this type of thyroid cancer is thyroidectomy, and the prognosis is generally favorable.
Follicular Carcinoma
Follicular carcinoma accounts for about 20% of all thyroid cancers, ranking second. It is more common in middle-aged individuals, with a female-to-male ratio of approximately 1:2. This cancer tends to develop more rapidly and can spread through the bloodstream to distant organs such as the lungs or bones.
Medullary Carcinoma
Medullary carcinoma originates from the parafollicular cells in the thyroid. The development of this cancer is often associated with a mutation in the RET gene. This type of thyroid cancer is relatively rare and typically occurs in women aged 30-60. It may be associated with a family history, and patients with a history of parathyroid or adrenal tumors may require genetic testing to assess the genetic factors involved.
Anaplastic Carcinoma
Anaplastic carcinoma is the most aggressive type of thyroid cancer and is more common in elderly individuals. This cancer develops rapidly, and often, by the time it is detected, it has already spread to distant sites and invaded nearby tissues. The prognosis is generally poor for this type of cancer.
Thyroid cancer has an unclear etiology, but it is associated with several risk factors, including:
- Family history/genetics
- Excessive iodine intake
- Exposure to radiation during adolescence
- Gender: Women are more susceptible to thyroid cancer than men.
Clinical Examination
Through physical examination and clinical assessments, doctors can inquire about the patient’s medical history, family history, relevant symptoms, and more. Clinical palpation allows doctors to determine if the patient has thyroid enlargement, whether it is uniform and symmetrical, if there are any other hard masses or lymph node swelling in the neck, and if the trachea is compressed due to thyroid enlargement. After the initial evaluation, doctors may arrange for further examinations such as thyroid ultrasound or fine-needle aspiration.
Thyroid Ultrasound
Thyroid ultrasound is a non-invasive examination. During the procedure, the doctor applies gel to the patient’s neck and uses an ultrasound probe to obtain real-time images of the thyroid. The doctor captures corresponding images during the examination for evaluation. Thyroid ultrasound helps doctors assess the size of the thyroid, the size and nature of thyroid nodules, blood flow around the nodules, identify calcifications, thyroid cysts, and evaluate if there is any swelling of neck lymph nodes.
Pathological Examination
After evaluation, the doctor may request a pathological report to provide further information for diagnosis. The most commonly used method is ultrasound-guided fine-needle aspiration. During this procedure, the doctor uses ultrasound to locate the lesion and extracts a small sample of cells using a fine needle (typically 21 or 23-gauge). The patient may experience mild discomfort, and only a single needle puncture is made. The extracted cells are sent to the pathology department for analysis. Pathologists use a microscope to observe the characteristics of the cells, identify their types, and particularly focus on identifying cancer cell features. All examination findings are documented in the pathology report. In addition to fine-needle aspiration for thyroid lesions, if necessary, the doctor may recommend fine-needle aspiration of enlarged neck lymph nodes for analysis.
After clinical examination, thyroid ultrasound, and pathological examination, doctors can generally make a diagnosis, determine the nature of thyroid lesions, and develop a treatment plan for the patient.
CT Scans
Neck CT scan is primarily used to assess whether the tumor has invaded nearby tissues, such as the trachea or major blood vessels, and to evaluate signs of lymph node metastasis.
Chest or abdominal CT scans can assist doctors in evaluating the possibility of distant metastasis in cases of anaplastic carcinoma.
Chest X-ray, electrocardiogram
These tests are performed to evaluate the patient’s physical condition and prepare for surgery.
Blood Tests: Thyroglobulin
Thyroglobulin is a substance secreted by the thyroid gland. After a patient undergoes a total thyroidectomy, the levels of thyroglobulin are typically maintained at very low levels. By monitoring the levels of thyroglobulin in the blood, doctors can assess for signs of recurrence or metastasis in patients who have undergone total thyroidectomy for thyroid cancer.
The doctor will first determine the stage of the patient’s thyroid cancer based on clinical information such as tumor size, lymph node involvement and number, and the presence of distant organ metastasis. Thyroid cancer can be classified into four stages according to the TNM staging system established by the American Joint Committee on Cancer (AJCC). The first stage is the earliest stage, while the fourth stage is the most advanced.
In addition to the TNM staging system, there are various other staging systems for thyroid cancer. These staging systems provide additional information to assess the extent and severity of the disease.
Surgical treatment
Surgical removal is the only curative treatment for thyroid cancer. Surgery can be divided into two types: total thyroidectomy and hemithyroidectomy, both of which are performed under general anesthesia. The choice of surgical approach depends on factors such as the size of the cancer, cell differentiation, clinical lymph node involvement, and the patient’s age.
During the surgery, the doctor will make an incision in the patient’s neck, usually hidden within natural neck creases to minimize visible scarring. Total thyroidectomy involves the complete removal of the thyroid gland. Since the thyroid is the only organ in our body that produces thyroid hormones, patients will need to take thyroid hormone replacement medication daily after surgery to maintain thyroid hormone levels. The total thyroidectomy procedure typically takes about 2 hours. As for hemithyroidectomy, the surgeon will remove the affected side of the thyroid gland while preserving the other side. The remaining thyroid can effectively compensate for the function of the entire gland, so medication is not required after surgery. The hemithyroidectomy procedure usually takes about 1.5 hours.
Radioactive iodine therapy
Radioactive iodine therapy is used to kill remaining thyroid cells by administering a radioactive iodine solution. Since the thyroid has the ability to absorb and concentrate iodine, the administered radioactive iodine will concentrate in the thyroid, releasing radiation to kill the remaining thyroid cells.
After a total thyroidectomy, the doctor may recommend radioactive iodine therapy as an adjunct treatment to ensure the elimination of all thyroid cells.
Chemotherapy
Most cases of thyroid cancer do not require chemotherapy. Chemotherapy is typically used for cases of undifferentiated cancer, especially when there are signs of metastasis, to provide palliative treatment.
Radiation therapy
Radiation therapy is generally used to treat recurrent cases, undifferentiated cancer, or cases with lymph node involvement.
After undergoing a total thyroidectomy, patients with thyroid cancer need to take thyroid hormone replacement medication daily to maintain normal thyroid hormone levels. The doctor may recommend TSH suppressive therapy to reduce the risk of cancer recurrence. This involves taking a higher dose of thyroid hormone replacement medication to suppress the secretion of thyroid-stimulating hormone (TSH) and minimize its stimulation on thyroid cells.
Thyroid cancer patients need to undergo regular follow-up visits to check for any signs of cancer recurrence. Typically, around six months after surgery, patients may undergo a radioiodine whole-body scan to check for any remaining cancer cells in the body. During each follow-up visit, the doctor will perform a clinical examination, and ultrasound examinations will be scheduled every six months. For patients who have undergone a total thyroidectomy, the doctor will also arrange a blood test every six months to measure thyroglobulin levels (also known as the cancer marker) to monitor for signs of cancer recurrence.