Most often, a thyroid cancer is found when the patient or the patient's health care professional feels (palpates) a lump or nodule in the lower front of the neck where the thyroid is located. It is most often painless and found incidentally, by chance. Occasionally, an enlarged lymph node may be palpated by itself in the more lateral neck or in addition to a thyroid nodule.Most patients have normal thyroid function at the time the nodule is discovered and have no symptoms related to hyper or hypothyroidism.It the tumor grows locally, it may cause symptoms such as difficulty swallowing food (dysphagia) if it compresses the esophagus (which is rare) or hoarseness if the recurrent laryngeal nerve that is located near the thyroid gland -- which controls the vocal cords -- is invaded and causes vocal cord paralysis.In children, lumps in the neck are found frequently. Most often they are not in the thyroid gland itself. Aside from swollen lymph nodes associated with infections like pharyngitis, strep throat, or an ear infection (otitis media), lumps should not be ignored. In pediatric patients, thyroid cancer is the third most common solid tumor malignancy and the most common endocrine malignancy. The first sign might be a lump that is felt in the thyroid gland.