Please Help - Thyroid Surgery - Remove half or all

[Louisiana_Kim]

Hello everyone, My name is Kim - I'm 34 years old with a 2.5 cm cold nodule in my right thyroid.  I had a FNB done and I will post the results below.  My surgery is scheduled for next Tuesday 8/19 to remove the right portion of my thyroid.  My doctor wants to go into the surgery only wanting to remove that half.  However, she (my doctor) says that if for any reason the quick biopsy that they do during the surgery shows any cancer, then she will remove the whole thing.  She also says that sometimes they do not find out that cancer is there until a couple of days later in the final pathology report and I would have to go back to have a second surgery to remove the other half.

My gut instinct after lurking around this board for the past few weeks is to get the whole thing out at once, but my doctor is totally against doing that if the quick(frozen) biopsy is negative for cancer.  Should I just look for another doctor?  I would like your input (or experiences) on what you would do.  Thank you in advance for taking the time to read this and offer input.

Kim

FNB results below on right thyroid nodule.

MICROSCOPIC DESCRIPTION:
Small clusters of follicular epithelia cells are noted within pap stained smears.  There is mild variation in nuclear size and shape.  The follicular epithelial cells sometimes feature crowding and overlapping.  Some of the follicular epithelial cells feature nuclear enlargement, fine chromatin, with small nucleoli, irregular nuclear membranes and copious eosinophilic cytoplasm, suggestive of Hurthle cell change.  Isolated aggregates of follicular cells feature ovoid nuclei with longitudinal grooves.  Occasional cells are binucleated.  More abundant clusters of atypical cells are noted within diff quick stained preparations.  Scattered neutrophils and hemosiderin laden macrophages are also present.  

FINAL DIAGNOSIS:
Clusters of atypical thyroid follicular cells.

COMMENT:  The morphology of the atypical follicular cells is worrisome.  Papillary carcinoma cannot be excluded with certainty.  Recommend excision for definitive diagnosis.  

[898]

If ultrasound report described nodule with well defined borders, the atypical cells most likely are confided to the nodule; if no swollen lymph nodes were found on ultrasound the chances are the nodule is pre-cancerous, so lobonectomy should be good enough,
in addition, the frozen biopsy is 99% accurate

[Louisiana_Kim]

Thanks for  the information  The US report didn't really descibe if the nodule had well defined borders.  I posted a picture of the nodule - is it possible for you to tell me if they look well defined to you?  I compared it to the pic you had on your page and my nodule does not look as circular.

Thanks again!

[898]

The nodule looks to me like of irregular shape with cystic portion [black]  and solid portion [light gray]; I may need to take look on the front view to be sure.
It does NOT have, however increased blood flow [supicious finding] [the tiny color specks-are outside of it.]

[mommy2two2008]

Hi Kim, I just wanted to send well wishes to you during your struggle.  Welcome to the community.  This place is great for information as well as inspiration!  Oh yes, I am also a Kim and also from Louisiana (Alexandria).  Will be praying for all the best for you! ~Kim

[Louisiana_Kim]

Hi Kim....I used to live in Leesville so we would often travel to Alexandria to shop.  Thanks for the welcome and prayers!

Kim

[Louisiana_Kim]

Thank you so much for taking a look at the picture.  I posted a few others that were on the CD from the ultrasound and I posted the radiology report.  If you get a chance, let me know what you think.

Kim

[ChitChatNine]

Your story is almost the same as mine and I was one of the unlucky ones whose frozen was fine, the final was fine on those 2 large nodules removed, but they found 2 other small tumors elsewhere in the gland.  So then further decisions what to do.

They don't like to touch the oher side as there are risks involved with taking a Synthroid type med for the rest of your life.  

I cannot say what is best for you; but I would suggest another opinion if time allows and, thus, you may be more comfortabl with your decision.

What you write is the norm (protocol) from what I understand and have experienced myself.

Keep us posted and WELCOME!

C~

[Louisiana_Kim]

Thanks for the welcome!  I really appreciate your information and it does sound like similar stories.  I'll let you know the outcome of mine.  Thanks again for being here!!!!!!!!!!!