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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
pet scan done for ovar. ca. metastisis and lg. thyroid mass did not show?
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.
pet scan done for ovar. ca. metastisis and lg. thyroid mass did not show?
by nalanala, Mar 05, 2007 12:00AM
It occurred to me at a later time that I had a pet scan done in January for ovarian cancer. Nothing showed up for thyroid. Since then, sonography and ultimate fna with one aspirate showed a follicular neoplasm with moderate cellularity and a paucity of colloid. Both the surgeon and the endo. as a second opinion, recommend full thyroidectomy within 1 month, which is causing me great consternation since I am going through chemo and frankly, I'd like to keep half of my thyroid. They say the mass based on palpation is almost 5 cm. The surgeon gives it a 50/50 chance of ca., and endo gives it > than 30. I am a 47yo female. Having extensively researched this, I cannot find any true, ultimate predictors of cancer in this case.
Do you agree with this recommendation and WHY DID THIS LGE. MASS NOT SHOW UP ON PET SCAN?
Thankyou so much,
Barbara
Do you agree with this recommendation and WHY DID THIS LGE. MASS NOT SHOW UP ON PET SCAN?
Thankyou so much,
Barbara
Doctor's Answer
by Mark Lupo, M.D., Mar 05, 2007 12:00AM
, Mar 05, 2007 12:00AM
5cm is large - but the chance of cancer is still about 20%. It should be removed, but if the opposite lobe has no nodules, then the initial surgery could be a lobectomy -- but if it's cancer, then a completion thyroidectomy will necessary.
PET findings for follicular lesions have been inconsistently helpful -- some studies suggest if it is PET negative, it is less likely to be cancer, but other studies suggest PET cannot predict cancer at all in these cases.
If possible, send the slides to a university (ie U Penn, Hopkins, U Florida) to make sure they agree it is indeterminant and needs to be removed. The size alone, in some experts' opinion, suggests it should be removed.
There is currently no way to predict CA confidently enough in these cases, and removal is the standard of care.
PET findings for follicular lesions have been inconsistently helpful -- some studies suggest if it is PET negative, it is less likely to be cancer, but other studies suggest PET cannot predict cancer at all in these cases.
If possible, send the slides to a university (ie U Penn, Hopkins, U Florida) to make sure they agree it is indeterminant and needs to be removed. The size alone, in some experts' opinion, suggests it should be removed.
There is currently no way to predict CA confidently enough in these cases, and removal is the standard of care.
