I had a rt side hemithyroidectomy and the results came back positive for papillary carcinoma with follicular variant. I had 2 nodules, the 1st one measured 1.1cm
Tumor focality: multifocal, ipsilateral
histologice type: pap with follicular variant
architecture: clasical:follicular
classical cytomorphology
margins are involved by carcinoma-distance of invasive carc. to closest margin 1.0 cm
tumor is totally encapsulated
tumor capsular invasion: present, widely invasive
lymph node-vascular invasion is not identified (doc told me the lymph nodes looked good)
the second tumor: .9cm
architecture:follicular
margins uninvolved by carcinoma, 1.0mm closest distance
totally encapsulated
tumor capsular invasion: present, minimal
pathologic staging: p T(m)1, NX, MX
additonal findings: focal thyroiditis, parathyroid within normal limits
Micro: Two sperical encapsulated tumors show char. cytology of papillary carc. generally showing a preserved follicular architecture. Small papillary growths are identified in the larger tumor. Both tumors show extension into the partially calcified capsule with at least focal extracapsular extension and are located with 1.0mm of inked surgical margins. No transected carcinnoma is identified. Elsewhere the thyroid gland exhibits normal arch. with scattered minimal foci of lympohoid infiltrates. There is a .4cm histologically unremarkable parathryoid gland.
I then had a completion thyroidectomy and the left lobe came back clean.
My question is should I have the RAI, I'm leaning towards yes due to the "widely invasive" tumor capsular invasion. I trust my doctor, he recommends that I do the RAI, I'm also getting a second opinion. I'm just looking for another one. I've read also about risk for other cancers can increase with the RAI. But does the risk of recurrence out weigh that?
It's just alot to take in and I want to feel positive with my decision. Any help you can give me would be greatly appreciated.