Where does thyroid cancer typically come back?

It depends: There are different types of thyroid cancer, with different patterns of recurrence, or where they are most likely to come back. Papillary thyroid cancer, the most common type, most often recurs in the lymph nodes of the neck and central chest (mediastinum). It can, however, spread to the lungs, liver, bones, and the brain in some patients. In most cases, though, it does not come back at all.

Follicular Cancer: Follicular thyroid cancer is somewhat more likely to spread, or metastasize to distant sites including the lungs, liver, bone, and brain without recurring in the neck.

Medullary Cancer: Medullary thyroid cancer involves the parafollicular cells, or c-cells in the thyroid. It is the most common type to run in families. Medullary thyroid cancer most usually recurs locally in the lymph nodes of the neck, or in the liver.

Anaplastic Cancer: Anaplastic thyroid cancer is the least common form, but also the most aggressive. It is usually fatal, and spreads by direct extension, so that the cancer cells push outside of the thyroid and grow into nearby neck structures, including muscle, the trachea (windpipe), and blood vessels, including the carotid artery and the jugular vein.