Aa
Is it thyroid cancer?
Hi Dr. Lupo,
In 2008 I had a thyroid US with the following results:
"Comparison is made to the recent CT scan of the chest dated 3/17/08 and on that examination at least one thyroid nodule is present in the left lobe. On today's examination the left lobe measures 4.52 x 1.66 cm. There is a mederate sized 1.92 x 1.52 cm nearly isoechoic mass in the upper pole of the gland. This corresponds to the CT abnormality. The right lobe measures 4.38 x 1.76 cm and contains several subcentimeter hypoechoic nodules. The isthmus is normal."
I did follow up w/ ENT who basically said nodlues are no big deal repeat US in 1 yr. Well, I waited 2 yrs. and the nodule on the left is bigger. Here's the recent US results:
"The rt. lobe measures 5.0x1.5x1.3 cm. The left lobe measures 4.5x1.8x1.8 cm. Several small nodules are identified in the rt. lobe. The nodules are hypoechoic and appear solid. The largest is in hte mid region measuring 6.3x4.3x5.0 mm. The left lobe of the thyroid demonstrates a large dominant nodule measuring 2.4x1.4x1.8 cm. This is somewhat hyperechoic relative to the remainder of the gland and has a rim of hypoechogenicity. There is some internal blood flow. An additional small nodule is seen in the 3mm range."
Recent Thyroid Panel shows: T3 uptake 31% T4 8.7 mcg/dL Free T4 Index 2.7 TSH, 3rd generation 2.84 mIU/L
I can see the left nodule has grown and I am actually experiencing some hoarseness in my voice which I assume is from the nodule. What are the chances this is cancerous? I do have a history of a malignant cancer, had a dermatofibrosarcoma protuberans tumor on my scalp which was removed in 2008. Have scheduled a follow-up appt. as my primary Dr. suggested, but this time w/ an endocrinologist. What should I expect at that appt. or what should I request be done? Sorry for the length of this post and thanks in advance for your time!
In 2008 I had a thyroid US with the following results:
"Comparison is made to the recent CT scan of the chest dated 3/17/08 and on that examination at least one thyroid nodule is present in the left lobe. On today's examination the left lobe measures 4.52 x 1.66 cm. There is a mederate sized 1.92 x 1.52 cm nearly isoechoic mass in the upper pole of the gland. This corresponds to the CT abnormality. The right lobe measures 4.38 x 1.76 cm and contains several subcentimeter hypoechoic nodules. The isthmus is normal."
I did follow up w/ ENT who basically said nodlues are no big deal repeat US in 1 yr. Well, I waited 2 yrs. and the nodule on the left is bigger. Here's the recent US results:
"The rt. lobe measures 5.0x1.5x1.3 cm. The left lobe measures 4.5x1.8x1.8 cm. Several small nodules are identified in the rt. lobe. The nodules are hypoechoic and appear solid. The largest is in hte mid region measuring 6.3x4.3x5.0 mm. The left lobe of the thyroid demonstrates a large dominant nodule measuring 2.4x1.4x1.8 cm. This is somewhat hyperechoic relative to the remainder of the gland and has a rim of hypoechogenicity. There is some internal blood flow. An additional small nodule is seen in the 3mm range."
Recent Thyroid Panel shows: T3 uptake 31% T4 8.7 mcg/dL Free T4 Index 2.7 TSH, 3rd generation 2.84 mIU/L
I can see the left nodule has grown and I am actually experiencing some hoarseness in my voice which I assume is from the nodule. What are the chances this is cancerous? I do have a history of a malignant cancer, had a dermatofibrosarcoma protuberans tumor on my scalp which was removed in 2008. Have scheduled a follow-up appt. as my primary Dr. suggested, but this time w/ an endocrinologist. What should I expect at that appt. or what should I request be done? Sorry for the length of this post and thanks in advance for your time!
MEDICAL PROFESSIONAL
The 2.4cm nodule should undergo FNA biopsy - most of these are benign.
Hoarseness may be from nodule,but could be other cause (ENT evaluation of the vocal cords is necessary to determine cause).
With this history, we would schedule your first appointment to include ultrasound and FNA -- but most offices don't do this, so not sure what to expect from the endocrine consult.
Hoarseness may be from nodule,but could be other cause (ENT evaluation of the vocal cords is necessary to determine cause).
With this history, we would schedule your first appointment to include ultrasound and FNA -- but most offices don't do this, so not sure what to expect from the endocrine consult.
Hi Dr. Lupo,
Went to Endocrinologist and he ordered FNA of left nodule and TPO blood test. Went for FNA yesterday so don't have results yet, but he said TPO showed inflammation of thyroid; I don't have the values of the TPO test. He wants me to go on Synthroid 50 mcg 1 x daily to slow down / stop growth of nodules and support thyroid. All my levels were in normal range so I am concerned about taking this and becoming hyperthyroid. Current diagnosis is Nontoxic multinodular goiter. I have read where you said this treatment isn't usually done in US for this diagnosis (my Endo is from the country of Georgia) and was wondering if I am correct in being concerned.
Went to Endocrinologist and he ordered FNA of left nodule and TPO blood test. Went for FNA yesterday so don't have results yet, but he said TPO showed inflammation of thyroid; I don't have the values of the TPO test. He wants me to go on Synthroid 50 mcg 1 x daily to slow down / stop growth of nodules and support thyroid. All my levels were in normal range so I am concerned about taking this and becoming hyperthyroid. Current diagnosis is Nontoxic multinodular goiter. I have read where you said this treatment isn't usually done in US for this diagnosis (my Endo is from the country of Georgia) and was wondering if I am correct in being concerned.
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