clinical significance of a hypoechoic thyroid nodule

[Pjeans]

I have had my left thyroid and isthmus removed, with a benign Hurthle cell tumor in the left lobe, and a very small papillary carcinoma in the isthmus.  There were no nodules in the right lobe.  Now, 6 weeks post-op, (and 3 months after the last ultrasound) I have developed a complex hypoechoic nodule in the right lobe, 6 mm in size.  I have been advised to wait four months and then to have a repeat echo.  Should I be concerned about waiting that long?  What is the significance of this nodule?


This discussion is related to Hypoechoic complex nodule.

[Kimmydee2]

I have Hashimoto's diagnosed by biopsy of nodule 12 year ago.  This nodule at first was under 1.0 cm in size.  My Labs are always within normal limits except elevated TPOab.  Since last summer I have started having dizzy spells, extreme fatigue and weight loss of about 50 pounds.  My labs are still normal.  This last u/s March 2010 my thyroid and nodules are considerably larger than previous three years ago.  The isthmus measures 5mm.  The right thyroid measures 7.3 x 2.2 x 2.1 cm.  The left thyroid measures 5.2 x 1.2 x 1.5 cm.  There is an inferior pole heterogeneous right isoechoic thyroid nodule measuring 2.6 x 2.5 x 1.7 cm with multiple cysts.  There are two new nodules on the left lobes 4 x 5 x 3 mm in size.  The impression was 2.6 cm right solid heterogeneous thyroid mass.  I have my FNA on 4-9-10.  I was supposed to follow up on this three years ago and let it go after my last FNA because I didn't have health insurance.  My last FNA showed suspicious cells with Hashimoto's.  I will keep all of you posted on my results.

[brunoray123]

my TSH (I think that was it) came back at 9 something instead of 4.5 and the Dr felt an 8 mm nodule.  Ultrasound showed either hyper or hypo, I don't remember - I see the ENT tomorrow.  I, of course, am panicked.  I did start taking the synthroid.  What does all this mean?

[ChitChatNine]

Why aren't they putting you on supression given the cancer diagnosis (big or small, it is still Cancer) ... ?  That is my thought ..... regardless of my other side not functioning again, they were going to supress my thyroid function.

C~

[Pjeans]

Hi,

I am not on any medication because my remaining lobe if functioning adequately, and the labs are good.

You are right about the stats the at autopsy about 30% have micros.  I have heard that from two pathologist friends and 3 endocrinologists who are professional colleagues.  

The 1.0 or close cm mark is the biopsy strategy we are using too.  However, it is still like targeting a needle in the haystack, despite the skill of the person doing the FNA under ultrasound.

Like you, I find the waiting the hardest part.  So far this nodule does not resemble the other two, but it may be too early to tell, or reactive tissue since I am not on medication.

Good luck!

[ChitChatNine]

I, too, walk in your shoes.  Jan '07 had 2 (2.0cm) beign follicular adenomas removed from right side and they found two incidental papillary micro's that were small, fully encapsulated with no blood supply and no lymph node involvement.

What were the particulars of the micro they found on the path report?  Did they ck lymph nodes during teh surgery?

I have a 4.0mm nodule on my intact side.  I go every 6 mos for serial ultrasounds to watch it closely.  Mine resmembles the 2 benign ones removed.  I am on synthroid for cancer supression.

Are you on Synthoid, too?

All my nodules they saw via ultrasound (current and past) were hypoechoic.

If yours grows closer to 1.0cm ask for a biopsy.

The waiting is the hardest; the not knowing; the waiting ev. 6 mos for an ultrasound.

In my case I had about 6 opinions and 2 said to have the other side out and 4 said not to in my case.

They say 30% of all people who die unrelated and have an autopsy reveal they have these micros.

WELCOME!

Cheryl