Papillary Thyroid Cancer with 24 Lymph Nodes

[BrenMichelle]

I am 33 and was diagnosed last week with Papillary Thyroid Cancer after a TT. The nodule on my right side was just under 3cm. They removed 24 lymph nodes and found cancer in all 24:(
I am scheduled to undergo RAI on Sept 20, 2012. Then will have a full body scan a few days later. My question is- anyone else have such a large lymph node involvement?
I know this is very treatable. I am prepared for yucky results of the scan because we are pretty sure there is more cancer- since all nodes they removed were cancerous. I am more concerned that I do not see any other people talking about such a high number of L.Nodes involved!

[wannabeinitaly]

Hi I had a TT  13 years ago at age 34, 6 months after the birth of my 4th child.  They removed 30 lymph nodes from my neck and upper chest (under the collar bone)  all showing cancerous cells the largest being about 4 cm.  I had the radioactive iodine treatment and body scan and all was good.  I have not had any problems outside of the usual parathyroid injury which was remedied by taking a calcium and vitamin D supplement.  No recurrence of cancer.  It sounds like your doc is very thorough and did a good job finding anything that looked suspicious while he was operating.  Good luck and stay positive!  I am sure all will be well with you too!

[BrenMichelle]

I appreciate the response! I will make sure to ask all this. I realized when reading my report that I actually have diffuse sclerosing papillary. I know this worsens my prognosis and it definitely freaks me out that there could be further mets than just within my neck.
I did not have a pre-op CT... just US. They said the lymph nodes were centrocervical.
If it has spread to my lungs- what is the treatment for that and what is my prognosis??

[Mark Lupo, M.D.]

This is not that uncommon.  At your young age, this is still stage I (assuminng no spread outside the neck - which will be determined on scan after I-131).  I assume you had pre-op ultrasound or CT that helped plan the extent of surgery.  If not, and all 24 lymph nodes were from the central neck (around the windpipe), then a good ultrasound to look at the lateral neck is necessary before I-131 planning to confirm there are not still large lymph nodes present that would best be addressed surgically prior to I-131.  Also -- if you had pre-op CT w/ iodine contrast, make sure your doctor checks urine iodine levels to confirm it is ok to have I-131.