In high risk patients (family history or post neck irradiation) and in patients with carcinoma of unknown origin ultrasound is very sensitive in detecting occult thyroid primary disease. Metastases to the thyroid can also be seen, most commonly from lung, breast, and renal carcinomas as well as malignant melanoma [38,39]. They are seen as hypoechoic nodules, occasionally with cystic change, but without microcalcification .
Cytological sampling of metastases is performed as safely as for primary thyroid malignancy.
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