Pathology report:
left submandibular mass excisional biopsy: features most consistent with lymph node metastatic medullary carcinoma
left lateral neck, dissection: metastatic medullary carcinoma in four out of sixteen lymph nodes was identified; the size of the largest nodal deposit is 1.2 x 0.3 cm; and no evidence of extranodal extension was seen
thyroid gland, total thyroidectomy, and central lymph node: medullary carcinoma, classical type (tumor location is seen in the left lobe, tumor largest diameter is 3.5 cm, no encapsulation, however lymphovascular invasion present, no multi-centricity
other pathology: the right lobe shows hyperplastic nodules with Hurthle cell changes; no parathyroid tissue was identified in this material
lymph nodes: the separate piece submitted in this container is a central lymph node "as oriented by the surgeon" and shows total replacement by tumor, the other smaller pieces show fatty tissue only