The patient almost invariably complains of a swelling in the neck in the thyroid region. Sometimes this is inside the thyroid gland and such lumps characteristically rise upwards towards the mouth on swallowing as the thyroid is tethered to the larynx which moves up on swallowing so taking the thyroid with it. On other occasions, the lump is in an adjacent lymph node to thyroid and indicates spread of the tumour to the neck lymph nodes. In the figure photo, one can clearly see that the young woman has a lump adjacent to her larynx on her left (but just to the right as one looks at the photo) which was indeed spread of a papillary cancer of the thyroid to a neck lymph node.
Rarely, the patient presents with breathlessness due to spread to the lungs or bone pains due to spread of the cancer to the skeleton.
