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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Do I need FNA?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Do I need FNA?
by alaw37, Jul 20, 2007 12:00AM
I was diagnosed in April with hypothyroid due to a nodule and placed on Synthroid at 25 mcg. Was told by ENT that nodule was on post. side of thyroid and affecting my trachea and esoph. and was too difficult to biopsy. Had all the usual symptoms of hypo. but chief complaint was(and is) wheezing. Esp. bad after eating. He increased the med to 50 mcg. in June and I still see no relief of symptoms. I now have pain in my right shoulder and collarbone area. I don't know my #'s but know antibodies were neg. CT scan found the nodule - no further diagnostics done - other than bloodand CXR. I had him to refer me to an endo. - not going until Aug. Am I right to seek a 2nd opin.? My family is full of cancer - including my 31 yr old brother(brain). I just can't help but feel I need further eval. I feel and look terrible - fat, balding, no libido. Is is typical to treat nodule with Synthroid - am I being impatient?
Doctor's Answer
by Mark Lupo, M.D., Jul 21, 2007 12:00AM
, Jul 21, 2007 12:00AM
Nodules do not cause hypothyroidism -- unless the nodule(s) replace the entire normal thyroid structure -- which is unlikely in the case of a single nodule.
US guided FNA is easy to do - the thyroid itself is next to the trachea and esophagus, so the nodules are often wedged in this 'tracheo-esophogeal groove' -- but still safe to FNA with a small needle using ultrasound.
Synthroid is no longer typically used to treat nodules unless there is concomitant hypothyroidism for other reasons (most common would be hashi, but your AB's are negative).
Sounds like the 2nd op is a good move. The other option is to surgically remove it as you seem to have some compressive symptoms. BUT, a good surgeon will want an FNA first in order to determine the extent of surgery.
US guided FNA is easy to do - the thyroid itself is next to the trachea and esophagus, so the nodules are often wedged in this 'tracheo-esophogeal groove' -- but still safe to FNA with a small needle using ultrasound.
Synthroid is no longer typically used to treat nodules unless there is concomitant hypothyroidism for other reasons (most common would be hashi, but your AB's are negative).
Sounds like the 2nd op is a good move. The other option is to surgically remove it as you seem to have some compressive symptoms. BUT, a good surgeon will want an FNA first in order to determine the extent of surgery.
