In the summer of 2008, Xiaoting, a girl from Anhui province, felt a lump on her right neck by chance and went to a local hospital where she was considered to have a right thyroid lump. In March of this year, Xiaoting found a lump in her right neck again with tenderness, and the local hospital considered that Xiaoting’s thyroid cancer had metastasized in her lymph nodes. Soon after the second surgery, a lump reappeared on the right side of Xiao-ting’s neck, near the back of her ear. This time, her family brought her to a specialized hospital for otolaryngology and head and neck surgery. Thyroid cancer is a relatively common malignant tumor of the head and neck, accounting for about 0.8% (male) to 2% (female) of all malignant tumors in the body. There are many types of thyroid cancer, including papillary carcinoma, follicular carcinoma, undifferentiated carcinoma and medullary carcinoma, and the biological characteristics of each type of thyroid cancer vary greatly. The biology of each type of thyroid cancer varies greatly. The common features of all types of thyroid cancer are lumps found in the thyroid gland, hard and fixed texture, and uneven surface. Patients are often diagnosed with one or more lumps on one side of the midline of the neck by chance, or they may be diagnosed with metastatic thyroid cancer after removal of the neck lump. If thyroid cancer invades the recurrent laryngeal nerve, it may cause hoarseness; if it invades or compresses the trachea, it may cause difficulty in breathing and coughing up blood; if it invades the esophagus, it may cause difficulty in swallowing. The thyroid gland is a normal tissue structure of human body and has the function of synthesizing, storing and secreting thyroxine, which has the function of promoting human growth and development and increasing human metabolism. Under normal circumstances, the thyroid gland can neither be clearly seen nor easily felt during a neck examination. If a thyroid lump or enlargement is found, you should seek early medical attention to understand the location, nature and relationship of the lump to the surrounding tissues with the help of ultrasound, CT and MRI, and perform a lump puncture to clarify the nature of the pathology. The papillary thyroid cancer that Xiao Ting has is a well-differentiated thyroid cancer with slow growth, accounting for about 80% of all thyroid cancers. Although papillary carcinoma can easily metastasize to the lymph nodes in the neck, sometimes the primary carcinoma is so small that it is not detected, but the metastasized lymph nodes in the neck are already very large. Although papillary carcinoma metastasizes to the lymph nodes in the neck at an early stage, the prognosis is still very good as long as the lesions in the neck are thoroughly cleared and treated with isotope 131 iodine after surgery. Taking into account Xiaoting’s specific situation, the hospital’s Department of Otolaryngology-Head and Neck Surgery formulated a surgical plan for her to remove the residual thyroid gland with dissection of the recurrent laryngeal nerve and to clear the lymph nodes in the neck, and performed the surgery on April 9. In the first month after the surgery, Xiaoting will receive 1-2 more isotope treatments. It should be noted that there are many pathological types of thyroid tumors, and standardized treatment plans should be selected according to the pathological types and clinical stages. For papillary thyroid cancer with tumor size over 1.5 cm, cervical lymph nodes and/or distant metastases, total thyroidectomy should be performed to facilitate postoperative isotope treatment. It is not advisable to leave part of the contralateral thyroid gland in the operation because the residual thyroid gland will absorb iodine and affect the effect of isotope therapy. In patients with metastatic cervical lymph nodes, thyroidectomy should be performed with a standardized cervical lymph node dissection rather than removing the enlarged lymph nodes alone. In addition, because of the close relationship between the recurrent laryngeal nerve and the thyroid gland, the recurrent laryngeal nerve should be routinely dissected and protected during thyroid surgery, otherwise the recurrent laryngeal nerve may be damaged, resulting in permanent hoarseness after surgery. Therefore, it is essential to seek standardized treatment from a specialist when a thyroid mass is encountered.