MRCP2-1555
A 48-year-old man presented to his GP after discovering high blood pressure readings at the local pharmacy. His blood pressure was measured at 180/100 mmHg in the surgery. The GP prescribed ramipril 2.5mg and titrated up to 10mg, but his blood pressure remained consistently high. Amlodipine was added, but had little effect even at the maximum dose. After a third agent failed to provide an adequate response, the GP referred the patient to the endocrine clinic.
During observation at the clinic, the man’s blood pressure was measured at 190/105 mmHg with a heart rate of 98 beats per minute. On examination, he was thin with a body mass index of 23 kg/m². His apex was diffuse and displaced with normal heart sounds. The chest was clear and abdomen was soft and non-tender with no evidence of masses or renal bruits. A hard, painless nodule was noted over his thyroid gland.
Further investigations revealed raised 24 hour urinary catecholamines and confirmed a diagnosis of phaeochromocytoma. The patient was treated with an alpha blocker and beta blocker while awaiting surgery. During this time, the thyroid nodule was also investigated and found to be a cold nodule on radionucleotide scanning.
What is the expected histological type of thyroid cancer in this case?