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Thyroid (Expert Forum)

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Need second opinion of Thyroid Ultrasound and course of diagnosis

Answered by

Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound

Thyroid & Endocrine Center of Florida Sarasota - FL

Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).

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MedHelp Member's Question

Need second opinion of Thyroid Ultrasound and course of diagnosis

by phansee, Apr 03, 2007 12:00AM

Tags: thyroid, ultrasound, D and C, Thyroid Ultrasound, biopsy, Cancer, lobe, neck, nodule, nodules, nuclear

I will not be able to include entire ultrasound results because the report is too long. Condensed (by me):Both lobes of gland are heterogeneous in echogenicity + echotexture. Again noted are bilateral nodules within both lobes. Three nodules in left lobe = L upper 6x3x5mm/L midpole 6x3x3mm/L lower pole 4x3x5mm. Punctate calcification in the mid pole of right lobe 2x2x2mm. Nodules within mid to lower pole in right lobe = larger 6x4x7mm + smaller 4x3x4mm. Two nodules in thyroid isthmus = 1x0.5x1.1cm and 0.5x0.3x0.5cm. IMP:Findings that are still most likely compatible with multinodular goiter although new nodules are seen on today's study. Correlation with Iodine 123 nuclear medicine imaging is recommended to rule out potential cold nodule. The 1 cm nodule in the isthmus is new and simply based on size criteria, biopsy should be strongly considered. Dr.: What is your overall impression (cancer?) and when should the biopsy take place? Should the biopsy be delayed until the Nuclear test is completed or should it be done immediately? I have been having neuro problems for 2 years that are still undiagnosed. Twitching, numbness in face/eyes, hands and feet (mostly left sided). Extreme heaviness in arms + legs at times w/ fatigue. Could nodules be pressing on nerves or spine? THANKS AHEAD FOR ANY OPINION YOU MAY BE ABLE TO PROVIDE ME ON PROPER COURSE OF DIAGNOSIS AND TREATMENT. Sorry this looks so compacted but I wanted to squeeze in as much info as possible. THANKS AGAIN!

Doctor's Answer

by Mark Lupo, M.D.

, Apr 05, 2007 12:00AM

<10% chance this is cancer. If the TSH is normal (ie not <0.2 in this case), no need for I-123 scan -- go right to FNA of the isthmus nodule. The nodules are not likely related to neuro symptoms.

Member Comments (7)

by phansee, Apr 03, 2007 12:00AM

To: Dr.

Dr.: I didn't have room for this in my first posting. Additional symptoms in last 2 1/2 weeks include swollen and sore glands under chin and on each side of neck. Neck achiness and pain that even radiates into right ear. Have had trouble swallowing for at least a year (modified barium shows left sided dysphagia). Have become short of breath recently and very fatigued. Feel hot all the time although temp is usually 97.6F. Have recently been diagnosed with low blood sugar and this also occurs intermittently. Occasional hoarse voice. Generally feeling very poorly. Could these symptoms be related to my mutinodular goiter? I apologize if I have given too much info in my 2 postings but I am worried about feeling so poorly and the possibility of thyroid cancer. Thanks again! I believe I made a mistake in my postings. I already posted this as a new post instead of a comment. I apologize for this. I am new to Forums.

by phansee, Apr 03, 2007 12:00AM

To: Dr.

If I had a brain or should I say "memory" I would be dangerous! More info: I am a 57 year old female and had radiation treatments on my thymus when I was a baby in the early 1950's. Sorry for all the additional comments.

by utahmomma, Apr 03, 2007 12:00AM

To: phansee

I'm not a doctor, just a thyroid patient. As you are aware (I'm sure) the calcification on your nodule is a bit disconcerting. As for the other problems you are experiencing: there isn't a lot of room in your neck. If your thyroid or nodules are enlarged there is a good chance that it is pressing on something vital. My daughter's largest nodule was pressing on her carotid artery and was endangering blood flow.

Please follow up with a FNA or a nuclear scan. With your symptoms, ultrasound results, and age this is nothing to mess with.

My best to you,

Utahmomma - papillary carcinoma survivor

by utahmomma, Apr 03, 2007 12:00AM

To: phansee

I forgot to add . . . the radiation that you underwent as a child is also disconcerting.

by phansee, Apr 03, 2007 12:00AM

To: utahmomma

Thanks for your reply and support. It is greatly appreciated.

phansee

by utahmomma, Apr 03, 2007 12:00AM

To: phansee

Trust your gut instinct

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