Path report after TT (9 days post op)

[crystalthegr8est]

Hello everyone,

I was hoping someone could give me some additional details as to what the next steps in the process would be for me. I had a FNA done a few months ago that came back as "suspicious for cancer". So, I had a TT on 4/14/09. The surgeon told me to think of it as a really big biopsy. Well, as it turns out the first thing he saw when he got in there was a very suspicious looking lymph node. He called a pathologist in right away and he said it was cancerous and to take it out. They then took out my entire thyroid along with 21 other lymph nodes from a central neck compartment disection. I received the path report on Monday and here is what it says:

"Cancer Case Summary Protocol:
THYROID: Resection

MACROSCOPIC:
Specimin Type: Total Thyroidectomy
Tumor Site: Right lobe, left lobe, and isthmus
Tumor Focality: Multifocal.
Tumor Size: Largest nodule is 1.4 cm.

MICROSCOPIC:
Histologic Type: Papillary carcinoma
Pathologic Staging (pTNM):
Primary Tumor (pT) - pT3: Tumor less than 4 cm, but showing minimal extrathyroidal extension (perithyroid soft tissues).
Regional Lymph Nodes (pN) - pN1b: Metastases to bilateral cervical lymph nodes.
Number examined: 21
Number involved: 14
Distant Metastasis (pM): - pMX: Cannot be assessed
Margins: Tumor abuts the inked anterior aspect of the resection.
Venous/Lymphatic (Large/Small Vessell) Invasion (V/L) Present

FINAL DIAGNOSIS:
1. Pretracheal lymph node: Metastatic Papillary Carcinoma
2. Total Tyroidectomy: Multifocal papillary carcinoma (Largest lesion 1.4 cm) extending beyond thyroid capsule, and encroaching inked surgical margin multifocally.
3. Central Neck Compartment, right aspect: Metastatic Papillary Carcinoma in nine of ten lymph nodes.
4. Left aspect of central neck compartment: Metastatic carcinoma in four of ten lymph nodes, normocellular parathyroid tissue noted.

My biggest question is if I am going to need external beam radiation due to the invasion of the lymph nodes. Does anyone know what my next steps are going to be? I have an apt with my endo next week, but would appreciate any thoughts or advice in the meantime. Thanks everyone!

[crystalthegr8est]

Thank you for responding, and providing more information about Utah. I appreciate it. Thanks, also, for the advice about doing a community search. I found a lot of information that is proving to be helpful. You mention getting more than one opinion. Would that be a second opinion on the thyroid cancer, or my treatment options? Thanks, again!

Crystal

[ChitChatNine]

Utah recently had intestinal surgery on an emergency basis .... she hasn't been online for a few days.  But you can do a community search on the upper right hand side and put in some of the keywords.

So glad you had those tumor removed ... you may want to get more than one opinion, too, is my thought.

Glad you are feeling okay ...

C~
incidental findings of two small micro's papillary
1/07

[crystalthegr8est]

Hi there, and thanks for responding. I am feeling really well actually. The first few days were a little tough, but after that I just feel better and better each day. The only thing I notice is that my neck is not quite up to par yet, and if I talk too much (for more than 30 minutes at a time) my neck gets really tight and I have some pain. Other than that I am pleasantly surprised with how little pain I have had. Do you know if Utahmomma comes on frequently enough, or should I send her a note myself? Thanks again!

[Justin1967]

Gee, I'm guessing Utahmomma would be the right person to answer your question.

I think you would be a just right candidate for RAI and I  think you are on the right track for external beam radiation. How are feeling after your cervical lymph nodes taken out?