Thyroid nodule recurrence?

[Liam617]

In Spring, 2009, I began experiencing a tight feeling in my throat, like a golf ball was wedged under my Adam's Apple.  Hoping it was just allergies or anxiety (I had read about thyroid cancer online and was worried that this was a symptom) I let it go until a couple of weeks until I noticed a small lump in my neck.  I immediately began tests (blood work, scans, ultrasounds, biopsy, etc.) and was diagnosed with a 2 cm nodule suspicious for Hurthle cell neoplasm.  My surgeon removed the left side of my thyroid and the ithsmus in mid June, 2009 and replanted at least one of my parathyroids in the neck muscle.  My tumor was diagnosed as Hurthle cell adenoma (no capsular or vascular invasion), and I was sent on my merry way.  Interim blood tests have shown normal thyroid levels and I have not been on any thyroid meds.  In the months that followed my surgery, I noticed a lumpiness on the left side where my thyroid used to be.  My assumption is that it was just scar tissue or inflammation.

I was feeling completely fine until a week or so ago when I started getting the sensation like there is a lump in my throat under my adam's apple.  Other than the lumpiness I noticed post-surgery (which is still there), I have not had any noticable changes in my neck.  I went for bloodwork yesterday and my thyroid levels are consistent with my December 2009 numbers (all normal).

The sensation in my throat could be allergies, but my mind goes down bad roads at times.  Could it be a recurrence?  I've read that Hurthle adenomas typically never recur.  Could I have a new nodule (am I predisposed to develop more because I've already had one)?  Could it be a different form of thyroid cancer?

I am scheduled for a thyroid ultrasound later this week, but would love it if anyone could help answer my questions.  I am preparing myself for the worst.

[Liam617]

Ultrasound showed no nodules and only one 3mm cyst on the remaining right lobe.  Am very relieved!!

[Liam617]

Here are the results from my thyroid tests and reference ranges.  If left out the Aug 09 figures as my surgeon said the numbers could fluctuate a lot in the first few months after surgery.  I had my surgery in June 09, so the May 09 figures were while I had the nodule on my thyroid:

Free T4 (range = .93 to 1.7): current = 1.59 (Dec 09 = 1.6, May 09 = 1.86)
TSH (range = .27 to 4.2): current = 1.2 (Dec 09 = 1.15, May 09 = .868)
Free T3 (range = 230 to 420): current = 366 (Dec 09 = 346, May 09 = 371)

[gimel]

It would help members respond if you will post your results for each thyroid test, along with reference range used by the lab.  

[Liam617]

Primary care physician not concerned with Free T3 number -- "as long as it's in the normal range" (which it is).  Please tell me this is all needless worry!!  LOL

Going for thyroid US tomorrow afternoon.  Wish me luck!

[898_1]

swellings larger then 1 cm can be felt by a patient or even seen durnig neck extension and swallowing.I may speculate it can be related to the parathyroid gland.

[Liam617]

I just got my Free T3 number: 366 (normal range per the lab is 230-420), so it's in the normal range, but toward the high end of normal.  This scares me, because it was 371 before my surgery last year.  It was down at 346 in December.  Should this scare me?  Is this evidence that I have some kind of bad development going on in my thyroid?

[Liam617]

Tamra:

Thanks for the response.  I had my blood draw on Monday and got the results for the TSH and Free T4.  Just waiting for T3.  So far, my blood numbers seem consistent with what they were in December, and both are normal.

When I discovered the nodule last year, I could feel something was wrong with my body (aside from the feeling that there was something in my throat, I had anxiety, sleeplessness, weight loss, an overall feeling that something wasn't right).  I don't feel that this time: other than the feeling that there is something in my throat, I feel fine.

It's funny you mention the leg and foot cramping, as I've been getting this occasionally over the past couple of weeks (prior to this, I'd get a single cramp once every six months, but lately I've had a few).  I've also found it tougher than usual to lose those last few pounds of winter fat this spring.  I don't know if that's significant or if the weight and cramping are just factors of being 42!  LOL  Still, I'd rather focus on eliminating the possibility that this is a cancerous nodule before I worry about Hashimoto's.

Any thoughts on the odds of a recurrence, whether Hurthle or another thyroid cancer type?

Liam

[TamraW]

Liam, I'm glad you came here for help. What thyroid tests were run? TSH?

I ask because TSH is a pituitary hormone and NOT a thyroid hormone. Your doctor should be testing and treating your FT4 and FT3 levels.

Next, did the doctor run your thyroid antibodies? Auto-immune thyroid disease commonly causes these nodules. Have you ever had these symptoms before surgery?

Rashes, hives, dry skin, fatigue, leg and foot cramping, low D, B12, iron, constipation, depression, fibro pain, hair loss, loss of libido, weight gain, gerd, heartburn? If so, then you could have Hashimoto's thyroid disease.

My mom had a similar case as yours 15 years ago. Doc took out the lobe and DID NOT test for thyroid antibodies. I wish he would have, because that would have made it a whole heck of a lot easier for me to find my Hashimoto's diagnosis.

Also, if you had these symptoms prior to surgery, you could have had Graves: Weight loss, anxiety, heart palps, chest pain, ear ringing, eye pain, sleep less...

Hashimoto's can be tricky and also sometimes exhibit Graves symptoms. The only way to know for sure is the TGab and TPOab antibody tests for Hashimoto's and the TSI for graves.

If doctors have never run these tests, then shame on them!

When you go to your next doctor's appt. do not let the doctor dismiss your worries based on TSH. Also, people with Hashimoto's generally don't feel well unless our thyroid hormone FT3 is in the top 1/3 of the range. If FT3 is low end, you may need thyroid hormone pills. My thyroid  hormone shrunk my nodules down to pencil points.

:) Tamra