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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Partial thyroidectomy scheduled
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.
Partial thyroidectomy scheduled
by ohioma, Jul 10, 2007 12:00AM
Hello, I am a 47 year old female with some past health issues. Nothing too serious - I have been diagnosed with Sarcoidosis, an autoimmune disease (I think read that this may be a risk factor in developing Hasimoto's disease).
I recently went to my primary care doctor for some pressure (like someone was pressing on my neck) on the right side of my neck, under my ear. This had been going on for many months. She sent me for CT scan and a mass was found on my right thyroid.
I was referred to an ENT who scheduled me for a fine-needle biopsy. The biopsy found abnormal cells. The ENT wants to remove my right thyroid and if he finds cancer, the whole thing. The surgery is scheduled for July 30. The only other thing I know is that my calcium levels are fine and he said this means I don’t have a parathyroid adenopathy.
The ENT said that there is 95% likelihood that it will be nothing (I think he meant no cancer). Is this true? Is it routine to schedule a partial thyroidectomy in cases such as mine, or are other tests recommended first? Is there anything I should ask? I pretty stressed out about the whole situation as this is my first surgery with general anesthesia. I have read the posts here and everyone seems to have so much information about their conditions, and I feel totally in the dark. Any help is very much appreciated.
I recently went to my primary care doctor for some pressure (like someone was pressing on my neck) on the right side of my neck, under my ear. This had been going on for many months. She sent me for CT scan and a mass was found on my right thyroid.
I was referred to an ENT who scheduled me for a fine-needle biopsy. The biopsy found abnormal cells. The ENT wants to remove my right thyroid and if he finds cancer, the whole thing. The surgery is scheduled for July 30. The only other thing I know is that my calcium levels are fine and he said this means I don’t have a parathyroid adenopathy.
The ENT said that there is 95% likelihood that it will be nothing (I think he meant no cancer). Is this true? Is it routine to schedule a partial thyroidectomy in cases such as mine, or are other tests recommended first? Is there anything I should ask? I pretty stressed out about the whole situation as this is my first surgery with general anesthesia. I have read the posts here and everyone seems to have so much information about their conditions, and I feel totally in the dark. Any help is very much appreciated.
Doctor's Answer
by Mark Lupo, M.D., Jul 12, 2007 12:00AM
, Jul 12, 2007 12:00AM
With the normal calcium, it is unlikely a parathyroid problem -- remember, sarcoid can also cause high calcium (for future reference).
I usually have the slides read by an expert in thyroid before suggesting surgery for an 'abnormal' biopsy. I use Dr. Massoll at University of Florida -- may want to have the slides sent there or to another expert. If is is suspicious or indeterminant then it needs to be removed.
I usually have the slides read by an expert in thyroid before suggesting surgery for an 'abnormal' biopsy. I use Dr. Massoll at University of Florida -- may want to have the slides sent there or to another expert. If is is suspicious or indeterminant then it needs to be removed.
I've enclosed a link which describes the "odds", so to speak, of a given FNA biopsy result leading to a definitive dx of cancer.
http://www.endocrineweb.com/fna.html
I am awaiting the results of my FNA biopsy, as well.
Hang in there,
Michele
p.s. IMHO, a 'better safe than sorry' approach is your best bet. In other words, were I in your position, I would go ahead and have the surgery (in fact, I would prefer the whole thyroid be excised, rather than leaving the other lobe to chance, only to have to have it removed later). In fact, there is some evidence to suggest that there are no good predictors as to whether or not a seemingly unaffected thyroid lobe is (or will become) malignant (i.e., http://www.tsh.org/research/summaries/recentlypublished/article_14.html )
Top Secret: That's what I was afraid of. 1/20 chance was too good to be true.
Rope: I was diagnosed with Sarcoid about 8 years ago when I had the chicken pox. I had a chest xray that showed enlarged nodes and then a bronchoscopy confirmed the diagnosis. I've never really had any symptoms from it and probably would never have known if I hadn't gotten the chicken pox.
I'm sorry that your thyroid mass was cancerous. I hope you are doing, and continue to do, well.
I'm trying to remain hopeful, so I may be starting to grasp at straws, so to speak :) It turns out that I have 2 cousins with thyroid masses that are controlled with medicine. So, I'm hoping it's one of those "runs in the family" things... But the surgery will remain on my schedule.