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Thyroid nodule surgery for biopsy
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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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Thyroid nodule surgery for biopsy

Dear Dr,

Firstly, I would like to say I commend the work you put in on this forum.

My fiancée is 23 and has just got her first FNA results back as inconclusive at the weekend. The doctor said that he looks for 5 things in the samples for a conclusive result and that he could see 2 but not the others. I understand that this was due to insufficient cells and too much blood in the sample. He did not suggest that any suspicious cells were present.

The dr found 3 incidental thyroid nodules during an ultrasound for something else. 2 were less than 6mm and cystic and the dr said they were benign from the U/S.  One of the nodules was 10mm x 6mm and showed vascular activity. It appeared to have clear margins/borders.

The dr carried out an FNA on the 10mm nodule due to the size and he could not rule out the risk of cancer from U/S. He was reassuring saying that they are common, her thyroid looked normal,  he wasn't overly concerned and he has recently done 68 FNAs and only 2 came back bad.

The ENT specialist has recommended surgery to remove a small section of the largest (10mm) nodule for a further biopsy. She is due be admitted on Friday.

From your experience, is this the best way forward?  Wouldn’t a repeat FNA be beneficial? If the nodule was 1mm smaller (i.e. <10mm) he wouldn’t have even done the initial FNA!

We are meeting the surgeon tomorrow to ask him a few questions so if you can give me some guidance it would be much appreciated.

Thanks in advance.
Regards
James
Tags: nodule, biospsy, surgery, FNA, Thyroid
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Sometimes with indeterminate biopsies, surgery becomes a diagnostic procedure.  This sounds like the case with your fiancé.  It was a relatively small nodule at 10 mm but with the increased vascularity there was a potential risk for cancer.  Hopefully the surgery proved this to be benign.
7 Comments
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Avatar_m_tn
We have just been to visit the surgeon to discuss the surgery planned for tomorrow. The dr plans to remove half of her thyroid (the half with the 10mm nodule and her FNA was inconclusive.

I am worried that this is a very hard/invasive/risky approach on a relatively small nodule that is not causing her any problems. Especially when we do not know whether or not it contains cancer.

The dr said that there is  70% chance that it will be benign. 30% chance of cancer.

Any feedback would be appreciated.
James
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Avatar_m_tn
Thanks Dr Lupo. She is recovering well and we get the results on Friday. I pray that they will come back benign!
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Avatar_m_tn
Dear Dr,

We have just been told that we will not get the results until the 24th February (3 weeks after surgery). Is this right? Seems like an awfully long wait!

The surgeon initially said one week but apparently he was mistaken...

Thanks in advance!

James
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Avatar_m_tn
Ignore message above. We should get the results on Friday.
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Avatar_m_tn
The biopsy results came back as benign colliod nodule. We are so happy and relieved! Thought I would post on here to reassure any future readers.
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Avatar_m_tn
Thanks for posting, Glad I found this site today, and so happy you and your fiancee had good news! I am new to this, just had test results back and I need to have an "uptake" done after finding a nodule on the right side of my thyroid through an ultrasound. I do not have all my information yet, just getting referred to a specialist at this point. I have difficulty with pressure against larynx and feel as if something is caught in my throat. I can feel the nodule or swelling on the right side with my fingers - which is how I discovered it in the first place when I was applying lotion to my face and neck last week.
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