Complex cyst thyroid nodule surgey only option

[sheelstew]

Has anyone any experience with nodules that are complex cysts?
I have a 3cm dominant nodule on my left node.I am only aware of it now because they told me I have it. My thyroid function and antibodies are normal. Thyoid scan says it is a cold nodule. I have had two ultrasounds 18 months apart which shows no change in size. I have had a FNA under ultrasound which was an inadequate sample. My Endocrinologist referred me for surgery and told me it would be a simple surgery to remove the cyst. The surgeon, however, told me I would have to have part of my thyroid removed and be on thyroid hormone tablets for the rest of my life. Has anyone undergone any other treatment for this? I have heard they sometimes treat these (if benign) with thyroid hormones, but have seen some research that says it dosen't really work. I have requested another FNA in the hopes it will give me more answers, but I'm reluctant to go down the road of surgery right now if the nodule is not really bothering me physically (just mentally!)If an FNA shows cancer then its a no brainer...surgery. Would appreciate any input Thanks Marie

[Mark Lupo, M.D.]

Marie,

Complex nodules have cystic (fluid) components. These commonly have inadequate FNAs b/c cyst fluid do not contain enough thyroid cells to see on the slide mad from the FNA. If it is stable in size and not causing symptoms, I see no urgent indication for surgery. If one lobe is removed, typically the other lobe is adequate for thyroid hormone production and meds aren't necessary (although this is not always the case as highlighted by a recent publication). Thyroid hormone suppression does not always help, but is often tried.

I would repeat the FNA before surgery. Doing this under ultrasound guidance increases the yield.

Good luck, ML

[Mark Lupo, M.D.]

Marie,

Complex nodules have cystic (fluid) components.  These commonly have inadequate FNAs b/c cyst fluid do not contain enough thyroid cells to see on the slide mad from the FNA.  If it is stable in size and not causing symptoms, I see no urgent indication for surgery.  If one lobe is removed, typically the other lobe is adequate for thyroid hormone production and meds aren't necessary (although this is not always the case as highlighted by a recent publication).  Thyroid hormone suppression does not always help, but is often tried.

I would repeat the FNA before surgery.  Doing this under ultrasound guidance increases the yield.

Good luck, ML

[sadandscared]

Hey Marie

I am in the exact same position as you. I also have a complex cyst. I had 2 biopsy's in 2 months and the cyst never went away. My results show either benign or say insufficient material. I have opted for surgery. I did not even see an endocronologist. To me, if there is any possibility that it is cancerous I feel it needs to be removed. I am totally scared about my surgery. It's just one week away. I think my cyst also needs to come out because it is causing me pain and at times it hurts to swallow and talk. Are you having that happen to you? You will be okay :)
Shari

[worrywart123]

I'm in the same boat.  Mine's a week from today (29th). I chose to focus on the positive.  I hear more good stories than bad.  I'll let you know!!  Good luck to both of you.  It'll be okay!  They know what they're doing!

[twisha]

A related discussion, surgery only option was started.

[Tay415]

A related discussion, In response to Complex Cold Nodule was started.