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Post thyroidectomy/ Papillary Thyroid Carcinoma
5 years ago my general doctor noticed a lump in my thyroid and referred me to an endo. I had 5 nodules, biggest one was about 2.5 cm. Had a FNA and all were benign. My levels were still good so my thyroid was working so we watched it. Less than a year ago I went in for a routine follow up and two more nodules had appeared but one had disappeared. We decided to wait and watch since the others were benign when tested. In May I started having pain in my neck that radiated up through my ears, it would change sides. Also with this I got an agonizing head ache in the back of my head, one I had never in my life had before. I was also having trouble swallowing and breathing when I was laying down. I also noticed that it looked like I had an adams apple (I'm female) and when I felt my neck I felt a huge lump right in the middle. I called my endo right away and she got me in for an ultra sound. One of the new lumps had doubled in size and was filling rapidly with blood.
On June 10th I had a total thyroidectomy, prior to the surgery I was feeling like I had the flu constantly and would intermittently get the head ache that radiated up the back of my head. On the 22nd I got the pathology back and the "tumor" had reached 6 cm, there was another very small tumor as well .06cm both were papillary thyroid carcinoma classic type. It also showed Metastatic papillary thyroid carcinoma in three of three lymph nodes but the lymph nodes were not removed apparently. I was with my endo alone when I got this information and honestly I was pretty shocked since the other nodules had been benign I believed these would be too. I probably heard half of what she was saying. I do know I will be having RAI soon. I swear she said I was stage 1 as well but the AJCC pathologic stage on the pathology report says pT3 N1a. I researched this and since I'm 46 that stage 3 right? I'm not understanding why they wouldn't have taken out the lymph nodes either. Any thoughts on this? I spoke briefly to the surgeon and she said something about the other nodules being benign but that doesn't make sense to me. I'm also having an ultra sound and some scans but I'm not sure what those are looking for exactly.
Any advice, thoughts or suggestions at this point?
On June 10th I had a total thyroidectomy, prior to the surgery I was feeling like I had the flu constantly and would intermittently get the head ache that radiated up the back of my head. On the 22nd I got the pathology back and the "tumor" had reached 6 cm, there was another very small tumor as well .06cm both were papillary thyroid carcinoma classic type. It also showed Metastatic papillary thyroid carcinoma in three of three lymph nodes but the lymph nodes were not removed apparently. I was with my endo alone when I got this information and honestly I was pretty shocked since the other nodules had been benign I believed these would be too. I probably heard half of what she was saying. I do know I will be having RAI soon. I swear she said I was stage 1 as well but the AJCC pathologic stage on the pathology report says pT3 N1a. I researched this and since I'm 46 that stage 3 right? I'm not understanding why they wouldn't have taken out the lymph nodes either. Any thoughts on this? I spoke briefly to the surgeon and she said something about the other nodules being benign but that doesn't make sense to me. I'm also having an ultra sound and some scans but I'm not sure what those are looking for exactly.
Any advice, thoughts or suggestions at this point?
I had and extremely similar diagnosis but my tuma was on the left side all my biopsies had come back clear I had a partial thyroidectomy to remove the left side in may and the "nodule" it was only then it was found to be cancer I had a total thyroidectomy and 6 lymph nodes removed in june and am now awaiting radiation therapy
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One is that T3 means that the tumor was more than 4 cm across or it has just begun to grow into nearby tissues outside the thyroid. Yours was 6 cm, which would make it a T3.
N1a means the cancer has spread to nearby lymph nodes... therefore, pt3n1a would mean papillary cancer with a tumor that's more than 4 cm across and has spread to nearby lymph nodes.
The other interpretation would be that Papillary Cancer Stage III, in your case (being over 45 yrs old), the following applies: "T1 to T3, N1a, M0: The tumor is any size and may have grown slightly outside the thyroid (T1 to T3). It has spread to lymph nodes around the thyroid in the neck (N1a) but not to other lymph nodes or to distant sites (M0)."
http://www.cancer.org/cancer/thyroidcancer/detailedguide/thyroid-cancer-staging
You would have to question your surgeon as to the reason the lymph nodes weren't removed, along with the thyroid. It's possible the surgeon didn't think the cancer would have spread, but I'd sure be wanting to find out...
I'm not sure what kind of scans you're having done... they could be checking to see if the cancer has spread anywhere else, which is very rare. Discuss all this with your doctor, so you know exactly what they did, why they did it, what they're going to do and why... don't leave anything to question.