This year’s 33-year-old Ms. Chen, June 14, 2014 unintentionally found a swelling in front of the left neck, although there is no obvious discomfort, or go to the local county hospital to see a doctor, diagnosed as “left lobe thyroid adenoma” and only under local anesthesia to do the swelling removal surgery, but postoperative pathology suggests that “left thyroid follicular carcinoma”! But after the operation, the pathology showed “follicular carcinoma of the left thyroid gland”! This was a blow to Ms. Chen, followed by anxiety and fear: How long can I live? What should I do? When she and her family were anxious, the local doctor suggested that she should go to our oncology center for further treatment. The patient came to our hospital and found Director Jin Guoping, an expert in head and neck cancer surgery. After detailed understanding of her medical history and consultation with experts from the Department of Pathology, she was finally diagnosed as “papillary carcinoma of the left thyroid gland, with part of the area being follicular subtyped papillary carcinoma”, and combined with the latest guidelines for the diagnosis and treatment of thyroid and the condition of the patient, Ms. Chen was diagnosed with “mass excision surgery” and “follicular subtype papillary cancer”. Combined with the latest thyroid diagnosis and treatment guideline and the patient’s condition, Ms. Chen’s previous “mass excision” could not eliminate the tumor, and it was likely that lymph node metastasis had already existed, which required further tumor and lymph node removal. “Extended resection of left thyroid cancer + lymph node dissection + left recurrent laryngeal nerve exploration”. Postoperative pathology indeed suggested that papillary cancer metastasis was seen in the excised left anterior cervical lymph node! Knowing that her surgery went well and the tumor and metastases were removed, together with the care and concern of Director Jin and the whole department, Ms. Chen finally smiled on her face after a long time! Now Ms. Chen has been discharged from the hospital, and Director Jin told her to check her ultrasound and thyroid function regularly. Director Jin reminds: Anterior neck lumps should not be ignored! Ms. Chen’s case is a “blood” lesson. Whether the mass is benign or malignant, pathological diagnosis is the gold standard. Thyroid swelling in the absence of tissue to do pathology diagnosis, can not rule out the possibility of malignancy, so the operation needs to be carried out under general anesthesia, both conducive to the operation of the doctor, but also to reduce the patient’s pain. Intraoperative swelling can send frozen pathology examination, half an hour (?). After half an hour (?), the benign or malignant nature of the swelling can be clarified, and then guide the next step of the surgical method, to avoid unnecessary secondary surgery and reduce the possibility of tumor proliferation. It is strongly recommended that patients who need surgical treatment for thyroid enlargement should undergo standardized surgical treatment in the Department of Head and Neck Surgery, where oncologists are able to grasp the scope of surgical resection and are more experienced in the treatment of malignant tumors in particular.