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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Waiting for what?
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.
Waiting for what?
by PeggyS512, Nov 06, 2009 01:22PM
I have many cysts and nodules on my thyroid (>20).
FNAB in 2008 of 3 of the nodules showed Hurthle cell adenomas.
Ultrasound today shows most are stable in size while 4 have increased. 6 nodules with microcalcifications (up from 3), 3 are now hypoechoic, 6 with central and peripheral blood flow, 1 now with ill-defined borders, and 3 now have comet-tail artifacts (which I understand is a good sign).
My TSH runs around .7 and T4 around .9
I am tired or exhaused regularly, have average body temp of 97.5 and other unexplained medical issues
(sleep, blood pressure, gastro, immune system).
My Endo says my thyroid is OK. Wait and Ultrasound again in 6 months.
Although these nodules may not be malignant, I wonder if they are somehow involved with (or a clue to) my other issues. I do not wish to have unnecessary surgery, but if we are only waiting for it to get worse, why wait? Is it possible for the thyroid to heal itself, or is surgery an inevitability?
FNAB in 2008 of 3 of the nodules showed Hurthle cell adenomas.
Ultrasound today shows most are stable in size while 4 have increased. 6 nodules with microcalcifications (up from 3), 3 are now hypoechoic, 6 with central and peripheral blood flow, 1 now with ill-defined borders, and 3 now have comet-tail artifacts (which I understand is a good sign).
My TSH runs around .7 and T4 around .9
I am tired or exhaused regularly, have average body temp of 97.5 and other unexplained medical issues
(sleep, blood pressure, gastro, immune system).
My Endo says my thyroid is OK. Wait and Ultrasound again in 6 months.
Although these nodules may not be malignant, I wonder if they are somehow involved with (or a clue to) my other issues. I do not wish to have unnecessary surgery, but if we are only waiting for it to get worse, why wait? Is it possible for the thyroid to heal itself, or is surgery an inevitability?
Doctor's Answer
by Mark Lupo, M.D., Nov 07, 2009 07:53AM
, Nov 07, 2009 07:53AM
Thyroid function (TSH 0.7) is normal and meds not likely needed.With all these "nodules" would consider testing TPO antibodies to see if this is Hashimoto's.
Benign Hurthle Adenoma is a surgical diagnosis, not an FNA biopsy diagnosis. Often Hurthle cells are seen in Hashimoto's. Would consider having the FNA slides sent for second opinion to confirm -- if they are "suspicious for hurthle neoplasm" then there is 15-20% cancer risk and surgery would be needed to make definite diagnosis.
Benign Hurthle Adenoma is a surgical diagnosis, not an FNA biopsy diagnosis. Often Hurthle cells are seen in Hashimoto's. Would consider having the FNA slides sent for second opinion to confirm -- if they are "suspicious for hurthle neoplasm" then there is 15-20% cancer risk and surgery would be needed to make definite diagnosis.
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