Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Benign or Malignant, Surgery or Second opinion
About This Forum:

Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Benign or Malignant, Surgery or Second opinion

Hello,

I have a left thyroid nodule that was found 02/20/12, through incidental findings of a CT scan, measured 3cm.FNA done 02/24/12 showed: clusters of benign epithelium in background of colloid and blood. My endocrinologist  advised to follow up in 6months for another ultrasound & FNA.

12/21/12 : Ultrasound: Left thyroid nodule AP 2.30cm, TV 3.40cm, SAG 5.34cm, V 21.9ml , echotexture: heterogenous
Ithimus measured IATH 0.13cm

2 small nodules were found on my right thyroid.
measurments as follows: right mid: AP: 0.23cm TV: 0.26cm, SAG: 0.45cm, V: 0.014ml
echogenicity: hypo & solid
right lower AP: 0.13cm, TV: 0.13cm, SAG: 0.19cm, V: 10.3ml
echogenicity: hypo & solid

FNA results: The biopsy demonstrates thyroid follicular cells in a microfollicular pattern without atypia in background of minimal colliod(confirmed by gemsa stain). This pattern may be seen in 3 possible settings: an area of follicular hyperplasia, within the setting of goiter(which is favored), a follicular adenoma or a follicular carcinoma. Repeat aspiration and followup is recommended

Lastest Labs drwan 01/23/12, TSH(1.45), free T4(1.3), free T3(2.9), TPO<10 Parathyroid Hormone, Intact(17)


My endocrinologist suggested that I should remove my entire thyroid.  

I saw a clinical endocrinologist for a 2nd opinion , who advised that that the results were not suggestive of cancer, but suggest a follicular adenoma.  My left thyroid is hypervascular verifed via color doppler. He made the statement  that he is afraid that I may have another episode of becoming hyperthyroid again and suggest I have the left thyroid tken out.  He also advised me  that I may have a 50/50 chance of having to take synthroid for the rest of my life. He suggested that I meet with a surgeon, who he works with.  

I am very confused and still not sure what to do. Should I have my slides sent to a expert for a more definitive answer, have another FNA, or have a partial thyroidectomy?

HELP!!!!

97953_tn?1193367871
This is a large nodule (5.3cm); I am unclear why the concern about another episode of hyper - is this a "hot" nodule?  If hot, then it is not likely cancer, but w/ the TSH of 1.45, thyroid levels are completely normal.  With the negative TPO, the chance of hypo requiring meds after L hemithyroidecomy is probably 25-30% at most.  The pathology report is vague - would send for second opinion but the overall description sounds benign.  We usually repeat FNA if there is not a plan to remove a nodule this large to help improve sensitivity of FNA cytology for large nodules.  However, with the size (5.3cm), many would recommend surgery....
Blank
Continue discussion Blank
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank