3.5 thyroid nodule

Hi.  My primary doctor felt a nodule in my neck and sent me for an ultrasound.  Ultrasounds show a 3.5 cm nodule, which looks like it is part liquid and part solid.  He said the solid part is cause for some concern and referred me to a general surgeon.  The surgeon wants to remove my thyroid and lymph nodes without doing any further testing.  He said they have to assume the calcification is cancerous and to be safe, it all needs to be removed.  He said a needle biopsy wouldn't be accurate because they might draw out good cells and miss the bad ones....????  This doesn't feel right to me.  Wouldn't it make more sense to be SURE that it is cancer before doing a surgery that would result in my having to take medication for the rest of my life?  I'm gong to call my primary this morning and see what he thinks.  A doctor friend in another state told me to go see a Head & Neck doctor, or an ENDO doctor.  Which type of doctor should I see?  Please help.  Thanks.  


This discussion is related to Thyroid Nodule.

[ChitChatNine]

Hi and Welcome,

I saw a primary care doc who found and read and ordered my Biopsy .. I was lucky it was all found by that type of doc .. then an ENT made the final decisions .. so I vote for an ENT or an Endo  when possible .. given most Endo's don't do surgery it's a neutral based opinion is what my primary care doc told me.

Calcification would be a reason for further concern I think ... I am not sure about doing an FNA with calcification if samples can be caught that aren't contaminated by the fluid, blood, etc.

Good ?

C~
partial 1/07

[thequeen44]

Thank you for yoiur response.  My primary is going to send me to an endo, and depending on those findings, I will figure out what to do.  I just feel like they didn't do enough to find out exactly what it is before deciding to just cut out the whole thing.  I realize I may have to get the whole thing taken out, but to me it makes sense to be sure.  My primary originally told me they would probably remove the nodule and I would still keep the rest of my thyroid and not have to take meds.  This surgeon seemed a little to ready to cut.  I also live in a small city, so if I do have to have surgery, I will go to a bigger city with a teaching hospital where I can find someone who specializes in thyroid surgery.  Thanks again.

[MANmom]

They can remove 1/2 the thyroid, you may or may not have enough thyroid function to compensate for the removed half.  3.5 cm is pretty big, but even if it is cancerous, it usually grows slowly, so you do have time to get a second opinion.  A biopsy may or may not tell you what it is, sometimes they can't tell.  The only way to tell for sure is to take it out.  You should, however, see an ENT, the thyroid is a very delicate operation, lots can go wrong if you don't have an experienced surgeon.  They should do at least 2 thyroid operations a week or more.  Can you tell us exactly what the ultrasound report said?  Was the nodule hypervascular?  Calcified? Irregular borders? Hypoechoic?

[melly1969]

Hello, I have a 2.8cm solid and cystic nodule. The nodule also has calcification and there is internal vascularity in the nodule

I had a FNB on this nodule and although it came back as benign, some follicular cells show hurthle cell change. I'm told this can sometimes be a concern. I will be having another FNB next week.

From what I'm told it is possible that in a FNB good cells can be drawn out and bad cells can be left.

Good luck :)

[thequeen44]

Hi.  I saw the endo and had a FNB.  It didn't show any cancer cells but there were also some follicular cells, which he said can sometimes indicate cancer.  He recommended that I have a hemi-thyroidectomy.  I have an appointment to see a head and neck surgeon in two weeks.  I think, now that I have done so much reading about it, that the right thing to do would be to have it removed.  Then I am 100% that it is not cancerous.  Thanks for everybody's help!!!

[MANmom]

You know, that sounds a lot like what I went through, I had "benign follicular clusters", I still had cancer.  After the right half came out, they found three micro tumors, no bigger than 2 cm (pin head).  They removed the other side 6 weeks later and found a big tumor 1.5 cm (cherry).  If they had biopsied the left nodule instead of the largest one on the right, I may have had an answer sooner.  Good luck, I hope you get an answer, the not knowing is the most frustrating.

[whatsthematterwithme]

I know this is an old post, but would you let us know how it all turned out? Hope you are okay. So many of us are in the same boat, it might help too, for us to know what to expect.