Cold Thyroid Nodule

[ChiliConCairn]

Hey everybody.  I'm just looking for some advice about my thyroid condition.

In June of last year, my doctor discovered a lump on my neck.  I went for an ultrasound and then had a needle biopsy done on it in October 2006.  These two tests led to the conclusion that the lump was a benign thyroid nodule, about 2 cm. by 2 cm. in size.  In February 2007, I went for a thyroid scan and learned that it was a cold nodule (not functioning).  I've been to an endocrinologist about all of this, and he wants to wait and see what happens with the nodule.  He wants to schedule me for another biopsy in the fall of this year.

Basically, what I'm worried about is the validity of the needle biopsy done on the nodule.  A surgeon (not a thyroid specialist) performed the needle biopsy, and the endocrinologist I was referred to after that was surprised to hear that the surgeon had only gone in with the needle 1 or 2 times - he seemed to think it should be done at least 5 times to get enough samples. That's when he ordered the scan and we learned it was a cold nodule (more likely to be cancerous than a hot one).  I'm just worried that his decision to not do anything until the fall might be based on incorrect results from that needle biopsy.

I'm an 18 year old female with no history of thyroid issues in my family, and no history of radiation exposure.  A couple times a week, my neck will hurt around where the thyroid nodule is and up to my ear on that side, which really scares me.  I told the endocrinologist about the pain, but it was pretty much ignored.  I'm looking for answers on what to do - should I ask for another needle biopsy sooner, or is it safe to wait until fall?  Is it normal to feel a sharp pain where the nodule is?

[Mark Lupo, M.D.]

It is possible to get an adequate sample with 2 needle passes technically, but would be most comfortable with this if done by ultrasound guidance and only in small nodules -- 2cm is a medium nodule and I would recommend repeat FNA under US guidance and see no reason to wait until the fall.  most cold nodules are benign though.  Pain radiating to the ear is not uncommon with thyroid irritation.  Would also test thyroid antibodies to see if there may be some chronic inflammation in the thyroid.

[Justin1967]

Hi

If I was you I would go and get another FNA done quickly. They should have stuck the needle in at least 4-6 times.  I also have a cold nodule and am awaiting surgery.

All the best..

Justin

[azqtpies]

Listen... no rush is needed.. if it were the big "c" waiting would not make a difference on your prognosis... Thryoid cancer is so slowing growing.. not to under sell it but you would be fine! I just had half mine removed in Jan that had been there for 2 yrs with benign FNA until last fall right  cold nodule became suspicious.. so I had surgery and it was BENIGN! 85% of ALL nodules are benign, so no need to panis stay proactive.. if your biopsy is benign I would wait. The surgery if need be is very easy, recovery is so quick and very very lil pain. I would do it agin and just might one day as I have a cold 1.7 cm nodule remaining on my left which is benign. So I do share in your feeling, fears and questions as I have been there as well. Either way DO NOT PANIC! you will survive  this either way....these are SO VERY common especially with women. Relax , keep up with your FNA's and ultrasounds do make sure they do your FNA guided by ultrasound.. much more accurate. One thing they truly never know exactly what it is with out removing it! you will be fine =)

k =))

[zindy]

I HAVE A COMPLEX NODULE THATS  COLD AND 5.2X2.6X2.6CM WE, HAVE BEEN WATCHING IT FOR 7YRS. STARTED OFF 2.5CM.  I HAVE LOTS OF PAIN IN EAR,NECK AND SORE THROAT AND HOARSENESS.  THE ENDO DR ( 2 ) HAS ALWAYS SAID ITS A RISKY SURGERY BECAUSE OF THE SCAR TISSUE FROM PRIOR THYROID SURGERY 18 YRS AGO. THEY ARE AFRAID FOR THE VOCAL CORDS?? I JUST TIRED OF FEELING THE PAIN AND BEING TIRED..I WISH THE BEST!!  ZINDY

[ChiliConCairn]

Thank you all for taking the time to answer my questions.  I really appreciate it - I've calmed down a lot about this now, and I'm more prepared to talk to my endocrinologist about what to do next.

[theresbarb]

need to know im not alone with this problem.dr.found nodule on thyroid on physical exam. went to have ultrasound to comfirm there was something there ,then onto having radioactive uptake scan ,which found cold nodule.now they want to do needle biopsy.so scared that there is somethng not right .have already had melanoma cancer.just don't know what to think .need to talk to someone who has been through this ,thanks.

[zindy]

i went to endo dr wed. for a fna with us guidance and he was so shocked how big it was(5.2 x 2.6 x 2.6cm) my is  a cold complex nodule.  he said its growing backwards(depth). and i have lots of pain in my ear and neck.  feels sometimes like tightness around my neck.  mine started out 2.5cm yrs ago, i wished i could've talked the dr in taking out before it got this big. i've had my left thyroid removed 18 yrs ago. tell your dr how you feel even if sounds crazy.  i so glad my dr did a guided ultrasound with my fna because thats when he eeally seeen how big it was and i think he believe my symptoms now.  (ear,neck pain,sore throat,hoarseness,tightness in chest etc. a few to see if you relate) so he said this needs to be removed!!  i wish you the best!!