Follicular Neoplasm while pregnant

[Julia8]

I am 33 years old, and am 13 weeks pregnant.  After a FNA, I was diagnosed with Follicular Neoplasm, and the endocrinologist has suggested a thyroidectomy by 20 weeks gestation.  I have 2 nodules, one right in the middle, the larger one being 1.9 cm.  I have a history of Hasimoto's.  

Would you have this surgery done while pregnant, or would you wait until after pregnancy.  This is my 5th pregnancy and 3rd miscarriage.  I have a son.  

Thanks for your thoughts.  

[estrelinha]

Really this is a hard decision, your ENDO must discuss that with your Obstetrics, may be someone over here had that experience. Good luck for you.

[utahmomma]

Here's a definition of follicular neoplasms from thyroid-cancer-net:

http://www.thyroid-cancer.net/topics/what+is+a+follicular+neoplasm

"Follicular neoplasms are thyroid nodules that may be benign or may be a form of thyroid cancer. This situation occurs when samples from a fine needle aspiration biopsy of a nodule reveal clusters of increased numbers of epithelial cells grouped together in specific patterns with small amounts of colloid present. This configuration marks a nodule as a particular kind of growth that is referred to as a follicular neoplasm. If the cells that have grown to form this nodule remain contained within a thin capsule of tissue that surrounds it, it is a benign thyroid nodule called a follicular adenoma. Alternatively, if the cells grow to penetrate the capsule of tissue to invade normal thyroid tissue or blood vessels within the thyroid gland, it is malignant, representing a form of thyroid cancer called follicular thyroid cancer. It is not possible to distinguish a follicular adenoma from follicular thyroid cancer on the basis of a fine needle aspiration biopsy sample. To make a definitive diagnosis, it is necessary to surgically remove the nodule so that it can be cut into sections and examined under a microscope to look for any evidence of invasion of normal thyroid tissue or blood vessels."

Okay - that being said, the two most common forms of thyroid cancer, papillary and follicular, are both very slow growing.  http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_thyroid_cancer_43.asp

Both carry a 95-99% cure rate.   *DON'T* jump to surgery now.  Talk to a good ENDO (who specializes in thyroids) or two, an oncologist, etc.   Personally, without a conclusive cancer diagnosis, I don't understand why they are pushing you for surgery DURING your pregnancy.  Did they see anything that may indicate a spread on a scan??

Utahmomma
papillary carcinoma
three sisters with papillary carcinoma, another with atypical (precancer), and daughter with atypical thyroid cells

[Julia8]

Utahmomma,

Thanks, I did read that already.  I'm thinking what you are thinking.  But, my very experienced endo said "I" really needed to have this surgery, so I'm thinking that my labs must have indicated something to him to suggest this, right?  Like the internet says, it is very slow moving.  But, what he said was that while this is true, if a little bit of it gets into your bloodstream, then it will become much more aggressive, very quickly.  I know that thyroid levels can fluctuate quite a bit during pregnancy, and I'm wondering if this is what he's thinking.  

Sigh.....

Spoke with my OB/GYN and she said, "clearly, this needs to be done right away".  Hmmmm....

Julia