thyroid

[velda50]

are oxygen levels effected by hyperthyroidism

[tito55]

I am very sorry but I forgot to mention this. Well the endo is waitng for a room at the hospital for her RAI. I asked if it was absolutely necessay and he replied yes. So a asked if there was any cancer left and he was not sure but was not happy with the Tg level of 8.1 and felt very confident that to play it safe he would recommend RAI so she is trying to  get her mind and body ready for it. I asked when should she start her low iodine diet and he relied that it was not necessay because her TSH level was on 04/07/10, 70.1 and by the time the RAI would be given it would be much lower. What do you think about all this? Thank you so much. Dr. Lupo

[tito55]

I was tring to remember the report by memory, and  I am very sorry for the confusion. I have a copy of the Pathology report in front of me and I will type it exactly the same for you to read and if you can give me your opinion on the need of RAI. The endo is waiting for a room in the Hospital to become available, for the RAI on my wife . Thank you for all your help, consideration, patience and time.

                                  
                                                            Diagnosis
1. Benign Parathyroid tissue.
2. "     "     "     "            "
3.Total thyroidectomy showing:
-      Foci of Thyroid papillary carcinoma, bilateral, up to 2.5 cm. in size.
-      The main tumor nodule located at the left mid and lower lobe of thyroid
parenchyma with partial involvemfent of left side of isthmus.
-      Capsular fibrosis, foci of calcifications and a few giant cells present.
-       Inked resection margin negative for malignancy.
4.Nodular benign thyroid tissue, no definite lymph node seen.

                                                     Comments
Tumor summary:
1. Type of tumor-     Papillary carcinoma.
2. Size of tumor-      0.4 and 2.5 cm. in size.
3. Grade of tumor-    Well to moderately differentiated.
4. Invasion beyond the thyroid capsule- Not idenified.
5. Lymphovascular invasion- Identified.
6. Number of tumor nodules - two.
7. Non-tumor thyroid tissue - Unremarkable.
8. Lymph nodes -    Not identified.
9. AJCC Pathology Stage  -  T2, NX, MX, Stage II.    

  Last questions  what do mumber 5 and 9 mean?   iMuchas Gracias!                            

[Mark Lupo, M.D.]

I usually don't answer new questions that are part of a previous thread......

But Stage 2 cancers usually require RAI, but not all cancers/total thyroidectomy patients do.   If her TSH is this high (70.1), now is the time to either treat with RAI or start thyroid hormone.

I am confused about the stage 2 comment -- as most 2.5mm tumors would be considered only stage I and would not need RAI --- would sit down with the doctor to go over this report.  If it is cancer less than 1cm without spread outside thyroid or into blood vessels or lymph nodes, then no RAI is needed in most cases.

[tito55]

Dr. Lupo I try to navigate in this site but I am still learning. I send messages and do not get responses, I think I am doing it wrong, well I will try again! Thisis tito55 just an update. The wifa had her TT and is recovering and is feeling the symptoms of Hypo hell. My question is why do Endos have pts. level out so low, because I took her to emergancy due to mean shaking of her hands and her calcium was 84 and her hormone level was 70.1? There is some hope the pathologist report came back good no cancer in the parathriod tissue and Lympnodes. The Thyroid was sliced and the surounding tissue had no cancer only the 2.5mm solid nodule had stage2 papillary carcinoma. The Endo stated " she might not need RAI". we are hopefull that this remains true. Question have you every heard of anyone not needing RAI after a TT?  

[Mark Lupo, M.D.]

answered.