Need opinions on treatment...microcarcinoma

[goitergirl]

Hi. I am a 30 yr old female, I had a multi-nodular goiter consisting of several complex cysts. One cyst was so big that the surgeon bypassed the FNA completely and opted for lobectomy. The frozen section was benign, and on pathology all the cysts turned out to be benign, however, the pathologist did find a 2.5mm incidental papillary carcinoma! It was located near the margin of the tyroid, but was still contained. It not even shown up on the ultrasound!

So, at first the surgeon suggests total thyroidectomy within the next week, but when I meet with him in his office, he says he has reviewed the case, and consulted witht the pathologist and several ENTs, and they feel that the other side can just be monitered for 6 months, and that they all recommend against compltetion thyroidectomy, because I am "low risk".

I asked him about my lymph nodes, he said he felt them during surgery and they did not "feel suspicious".

I am going to see an endocrinologist, but in the meantime I am worried about the possibility of caner on the other side of my thyroid. What would you recommend?

[quiltcrazy]

My 18 year old grandson has been choking feeling for months.  He has had swollen lymph node under arm a few months ago.  They have treated him as  sinusitis etc. until he started panic attack from the feeling of suffocating.  The good doctor we finally got in with found a 2 inch mass in neck. Anyone have this with younger person?  He is 18 and only wweighs 130 lb.  I know it is making him burn food but  I mean they have let it go so long I am sick.  I am just looking for helpfui answers. linda

[Mark Lupo, M.D.]

Would watch the other lobe -- if there are any nodules, they need FNA and consideration for completion thyroidectomy.  Up to 40% or more of these papillary CAs are multifocal -- meaning a good chance there is soomething on the other side.  A completion thyroidectomy would be the most aggressive route and may offer peace of mind, but if it was only one small spot - observation is usually reasonable provided that this was a classic PTC and not any aggressive subtype of PTC.  T4 therapy with a TSH goal of around 0.2-0.4 may be worhwhile as well.