Thyroid nodule - should I worry?

[lana99]

Hi, I'm 40 year old. Had an ultrasound, that showed a single nodule 0.96x 0.72 x 0.4 in the right lobe of the thyroid gland. My blood tests are fine. The doctor said that it is most likely adenoma and nothing to worry about, just repeat the ultrasound in 6 months. Should I go to the endocrinologyst or just wait 6 months?

Thank you!

[scaredandconfused84]

Did you get a total thyroidectomy? I have papillary carcinoma. Getting mine out January 2nd. Did you get Radioactive Iodine Therapy?

[lana99]

Sorry, I never answered your question. I didn't visit the site since 2011. Now I am back because of possible cancer recurrance.Really hope everything went well with you!!!

[Ditsy70]

Hi Lana

How are you doing? Ive stumbled across this forum by chance whilst truing to do a bit of my own research on thyroid cancer.  I have only just had my ultrasound on my thyroid today (Mon) and have an appointment with my GP to discuss the results on Wed (which seems an eternity!)...I have the ultrasound pics on me and have been scouring them trying to understand what is possible on them that could cause concern! (I know i sound paranoid but at 42 and with 3 kids I dont want to leave anything to chance!).

The pics should several "masses" one of which says distance 4.11cm x 1.51cm (left lobe long) and another 4.95cm x 1.78cm (right lobe long)....could this be something innocent or is it more likely to be something to worry about? (It does seem rather big?)

Sorry to sound so vague and I know I should just wait for the GP to fill me in but I am very anxious about this one!

All the best,

AnnieOK

[lana99]

Thank you very much for your answers - always so informational.
Sorry didn't post for so long. I had right half of my thyroid removed. No other treatment is needed. No mets. to lymph nodes (thanks GOD). Its been a month since my surgery. I feel fine and back to work. All blood work is good, will need to follow up in 6 months. My voice is not 100% back yet.
I'm a little worried right now because i have very strong pain somwhere in the back of my throat only on the left side. I have this pain for about 2 weeks now and not sure if it is related to the surgery I had. I have this pain ONLY when I swallow liquids. Do I have to call the surgeon back or just see my regular doctor? To tell you the truth I'm avoiding doctor offices (kind of stupid , I know).
Thanks again!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[898_1]

The neck ultrasound images are reviewed for lymph nodes larger then 1 cm; if any are found, the the biopsy is used to check them for cancer cells; such procedure is commonly done during the surgery for thyroid removal.
This is what I found about papillary cancer:
It occurs in women at a ratio of 3 to 1 to males
Its peak onset is between the ages of 30 to 50
About 85% of papillary thyroid carcinoma is caused by radiation exposure (but radiation- caused cancer has extremely low reocurrance rate)
It spreads to the lymph nodes of the neck in more than 50% of the diagnosis
Spreading to other areas such as the lungs or bones is very uncommon
Prognosis is directed related to the size of the tumor;
Cure rate overall is very high especially in young patients with small tumors

[lana99]

Thank you 898!
Do you by any chance know how lymph nodes are checked? I have an appointment with head and neck surgeon on 08/31 - what questions should I ask? Thanks again - your answers always help!!!!

[898_1]

Based upon it's size it is most likely 1st stage so it is unlikely to spread; the next step is to check the lymph nodes in the neck to make sure they are clean.
Best of luck with your treatment.

[lana99]

Got my biopsy results on Friday - cystic papillary carcinoma. Ughhh
Im not scared, but very concerned and upset. Will see head and neck surgeon tomorrow... I'm praying for that cancer to be local without ANY metastasis..............................

[lana99]

ok. had the FNA biopsy on Wdneday. They have pathologyst on site, and I was told that I'll get preliminary results right away. Unfortunately not with my luck :(. What they told me is just that the nodule is vascular on Doppler US and that they can't tell me preliminary result because my case is complicated. Now I'm really worried - does it mean they saw something BAD and didn't want to tell me before they make sure?

If you had similar situation or may be you can give me some more info, I'd really appreciate it.

Thanks!!!

[lana99]

Thank you for your answer. I know that Doppler was done, but there is nothing in the report about it. The doctor gave me a refferal for biopsy under ultrasound - probably will go next week. I'm a little nervous that it might be cancer. Will keep my fingers crossed.

[898_1]

The "soft tissue" refers to the everything that is not made out of bone material, so it may not be a good word choice for this report.
Have the ultrasound technician performed the Doppler color image for this nodule (for the blood flow pattern?)
If internal blood flow in the nodule is observed, the next step can be biopsy under the ultrasound to obtain the tissue sample from the solid part of the nodule.

[lana99]

Here I am - back again. My thyroid nodule is still there and grew a little. I can feel it when I swallow. Went to ultrasound. Here is what report sais: In the mid right lobe there is over 1 cm heterogenous partially cystic nodule with internal soft tissue nodule. FNA is advised.


My question is - what is soft tissue nodule? I know that nodule can cosist of fluid and solid parts, but never heard about soft tissue nodule.

Any info. would be greatly appreciated.

[898]

If this lump moves up as you swallow, this can be orignated at thyroid; if lump is not moving, it can be inflammed artery wall [it should pulsate], or lymph node.
If lump is painful or getting bigger it is good idea to check it professionally.
typically the minor inflammations should not last more then few days

[lana99]

Hello,
I'm back with another question. About 2-3 weeks ago I noticed a lump on the right side of my neck (same side as the thyroid nodule). But the lump is much higher than thyroid gland. Actualy it looks like the artery is a little bit swallen (it is located right on the artery). Should I worry, is it somehow related to my thyroid?

Thanks a lot!
Lana

[Shherry]

Hi Lana,

I'm in the same boat as you ... I have 0.8 cm nodule (complex) but both sides of my thyroid are slightly enlarged too.  I had been thinking I wanted to just get the fna and get it over with but the endo said he may not even be able to get a good sample at that size.  He did give me Synthroid though (very small dose) to see if it would shrink and do the recheck in 6 months.  I'm a worry wart though and hate to wait the 6 months but guess I don't have a choice.  Good luck!

[898]

Lana, the final decision is yours, however you could wait 6 month and re-test with the ultrasound if:
The re-test will be done on the same equipment to insure the “repeatability’ [my professional term] of the measurements;
This was your first ultrasound, and no thyroid ultrasounds were done before, so the nodule could be there for several years already
You do not have increased chances for thyroid cancer [family history; living on radioiodine contaminated areas at early age, etc.
The nodule is located at the place where its’ growth can be easily spotted, such as anterior neck, not the rear pole.

[lana99]

898 and JLWH!
Thank you very much for your answers. Talked to my doctor, he thinks that is is better to do another ultrasound in 6 months. Can I just ask him to send me for FNA or it is up to him?

[JLWH]

Lana, I'd not worry too much about having the biopsy done.  I've had a couple of them and they are not at all anything to panic about.  If you can stand a blood test, you can certainly handle this with ease as the needle is even finer than those used for blood tests!  

It's likely that there's not much to worry about, but better to be on the safe side for the bit of time that it would take to have it done.  And, the fact that it's a warm nodule as opposed to a cold (while as 898 has said already) means that there's more or less an equal chance of a malignancy, they do tend to be less stressed out over a warm nodule than a cold one and especially since yours is not even at the 1 cm mark.  It's just a precaution that puts everyone's minds at ease.

Best of luck and wishes!

[898]

yes that's correct

[lana99]

So, my next step should be FNA - is it right?

[898]

If mass is not visible on the scan it means the nodule is "warm';as it takes same amount of RAI as surrounding tissue; such "warm" nodules as well as "cold" [not iodine taking nodules] have equal malignancy chance.
the Hot nodules which show the INCREASED uptake compared to the rest of the gland are beningn in 99.99% of the cases

[lana99]

Hello ,
Just got my Thyroid scan and uptake results back. It sais 24 hour RAI uptake is 24% which is normal. Thyroid scan reveals normal activity whithin a normal appearing left and right thyroid lobe. A mass is not identified.

Now I'm confused. How is it possible that mass was identified on ultrasound and there is no mass on thyroid scan? Which one is more accurate? What should be my next step?

Thanks a lot!!

[lana99]

Thank you very very much! Have a good Labor day weekend!

[898]

Unless the nodule is HOT, the nodules are subject to biopsy. If it is at easy to reach location and ultrasound guidance will be available to get sample from the SOLID portion of the complex mass, for the pease of mind you can insist on biopsy; [if nodule will be 2 times smaller and only cystic or only solid, i would not mention biopsy at all].