Most common malignancy in a longstanding goiter is -

Ans. is 'a' i.e., Follicular Carcinoma "An increased incidence of cancer (usually follicular) has been reported from endemic areas. Dominant or rapidly growing nodules in longstanding goiters should always be subjected to aspiration cytology." - Bailey & LoveAbout Follicular Carcinoma (FTC)o FTC are second most common thyroid malignancies, more common in iodine-deficient areaso More common in women (Female: Male ratio of 3:1)o Mean age of presentation is later than papillary Ca (~ 50 yrs)o Multiple foci are rarely seen and lymph node involvement is much less common than in papillary carcinomao Blood borne metastasis is common with spread to bone, lungs, liver and elsewhere.o In less than 1% of cases, follicular cancers may be hyperfunctioning (warm nodule on scintiscan), leading to symptom of thyrotoxicosis.