Thyroid mass

[lara1228]

I have been to an Endocrinologist due to an enlarged thyroid.  The sonogram came back showing that I have a 6.1 x 2.2 x 2.0 cystic mass on teh right lobe.  The Scan came back indicating that I have a toxic nodular goiter with hot nodules in the right lobe.  My blood work all came back with normal hormone levels.  The doctor sent me for an FNA, but the doctor he sent me to did not do it because he said he recommended that I should have the mass surgically removed.  He called my endocrinologist and he agreed that the mass should be removed surgically.  I'm just curious what kind of procedure this is, and if there are any other ways that the mass can be treated, since I would rather not have a surgical procedure if this can be avoided.  Thank you.

[Mark Lupo, M.D.]

This is a large mass (>4cm) - typically surgery is the best option.  I usually do an FNA to make sure there are no suspicious cells (unlikely if this was "hot" on scan) as the presence of suspicious cells would potentially alter the extent of surgery.

Surgery to remove the right half of the thyroid can often be done without spending the night in the hospital but you would require general anesthesia.

The only alternative is I-131 treatment which may shrink the mass.  about 60-70% of patients have a 40-50% reduction in the volume of the goiter with this treatment.