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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Hashimoto's, thyroid nodules and incidence of cancer
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.
Hashimoto's, thyroid nodules and incidence of cancer
by Babs16, Oct 19, 2007 10:00AM
Hi Dr. Lupo,
I am 46 years old and was diagnosed with Hashimoto's thyroiditis in Nov 2006. I have been on synthroid 0.05mg since Nov 2006 and my last TSH was 2.98, six months prior it was 1.1
I have also had two ultrasounds of my thyroid--the first was 8 mos ago--the results indicated an 8mm focal soft tissue nodule--hypoechogenic--in the left upper pole and a 6mm focal area of calcification in the lower midpole of the right lobe. On the right side of my neck there is a normal appearing 2.3cm x 0.4cm x 1.1 cm lymph node. Both lobes demonstrate increased vascularity and are normal to slightly large in size.
A follow-up US was done in May 2006-- "Thyroid gland is normal in size and slightly heterogeneous. A 6 mm calcified nodule is present in the right midpolar region and a 10 x 8 x 5 mm hypoechoic nodule is present in the left upper pole laterally.
My question: Should I have a biopsy (?FNA) of the larger nodule or just repeat the US at regular intervals? Does Hashimoto's predispose an individual to cancer? And should I being seeing an endocrinologist--my family Dr. doesn't feel it is necessary.
Thanks.
I am 46 years old and was diagnosed with Hashimoto's thyroiditis in Nov 2006. I have been on synthroid 0.05mg since Nov 2006 and my last TSH was 2.98, six months prior it was 1.1
I have also had two ultrasounds of my thyroid--the first was 8 mos ago--the results indicated an 8mm focal soft tissue nodule--hypoechogenic--in the left upper pole and a 6mm focal area of calcification in the lower midpole of the right lobe. On the right side of my neck there is a normal appearing 2.3cm x 0.4cm x 1.1 cm lymph node. Both lobes demonstrate increased vascularity and are normal to slightly large in size.
A follow-up US was done in May 2006-- "Thyroid gland is normal in size and slightly heterogeneous. A 6 mm calcified nodule is present in the right midpolar region and a 10 x 8 x 5 mm hypoechoic nodule is present in the left upper pole laterally.
My question: Should I have a biopsy (?FNA) of the larger nodule or just repeat the US at regular intervals? Does Hashimoto's predispose an individual to cancer? And should I being seeing an endocrinologist--my family Dr. doesn't feel it is necessary.
Thanks.
Doctor's Answer
by Mark Lupo, M.D., Oct 21, 2007 08:26PM
, Oct 21, 2007 08:26PM
Hashimoto's does appear to increase cancer rates, but most of these are still benign. FNA would be helpful to confirm this is just an area of inflammation and not anything suspicious.
I have symptoms that are very similar to yours, meaning that my thyroid is enlarged on one side. It also increased in size between my first and second scans (taken 4 motnhs apart). However, my thyroid levels are apparently normal.
From what I understand, gender, genetic predisposition and age play a large role. Women get thyroid cancer 3 times more often than men. I read somewhere that women in their childbearing years, or at menopause are also at a greater risk.