Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Questions to ask surgeon
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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.

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Questions to ask surgeon

I have a very large multinodular goiter with autonomy on the (R) side and my endo has recommended surgery. I have an appointment with the surgeon to discuss the thyroid operation. I would appreciate receiving any advice re what are the important questions I need to ask the surgeon about this procedure?
Thank you in advance.

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Your question brings up many different points. If there is a concern for cancer (usually not the case in autonomous multinodular goiters) then removing the entire thyroid is indicated.  If there are nodules on both sides then taking the whole thyroid even if no concern for cancer may be appealing in that there would be not continuous concern/monitoring of the nodules.

Have you been offered I-131 treatment?  This could treat the autonomy and often shrink the goiter.  If, however, there are compressive symptoms then surgery may be a better option as I-131 may take a few months before decreasing goiter size.

The surgeon will discuss risks including parathyroid gland removal and damage to nerve going to vocal cords.  

I think the most important questions are 1) Is surgery the only option and 2) if so, how much to remove (ie lobectomy vs total thyroidectomy)
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Thanks for your reply. I will definitely take up your suggestions when I meet with the surgeon to discuss my options.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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