Follow up answer/question

[Mucka]

You can read my/your posts on an earlier thread........The endo surgeon I am seeing is experienced and is chief of surgery of this particular major hospital and hails from the UK I believe (I am in Canada).  He is my second opinion.  I had to travel off Island to see him.  My first was an ENT surgeon, who said I had acute thryoiditis which I obviously don't. My internist and radiologists don't like the look of the nodule.  My endo surg is going to only do a partial thyroidectomy in hopes that my right side starts producing again.  The nodule is quite large 5.2x4x3.7 and it is quite visible.  My TSH is suppressed. The uptake scan suggested this :  distribution of the radiopharmaceutical demonstrates a large amount of increased uptake of the radiopharmaceutical in the region of the left lboe of the thyroid gland generally, with a rather poor/no trapping of the radiopharmaceutical in the right hemithyroid.  Distribution of the radiopharmaceutical in the left hemithyroid does demonstrate inhomogeneous distribution with a tiny photopenic area long its inferior lateral aspect of the left hemithyroid.  This is an abnormal appearance.  This corresponds to the large nodule as previously noted on utlrasound examination.  24 hr uptake just above upper limits of normal at 28%.  The ultrasound, other than what I have already stated says ....multiple small foci of psammamatous calcification noted throughout the nodule andthat there are defined margins c with no adjacent adenopathy. Multiple small foci of psammamatous calcification noted throughout the nodule.

I had no hyper symptoms at all throughout this but since starting the Tapazole......I am extremely tired and sleeping a lot though last TSH was still supressed and the nodule has not shrunk a bit.

Anything else you can add would be greatful!  Sx is coming soon!!

Thanks, again!

ps: I think we need to nominate you for a show on Oprah!!!!

[Mucka]

Thank you very much, Dr. Lupo!  I was aware that those were my two options.  They did tell me that in most cases, at my age (32) and healthy otherise that the usual method is to do RAI but there is just something suspicious about this particular case.  I will keep you updated on the path when I recieve it back.  Sx is one week from tomorrow.

[Mark Lupo, M.D.]

The "hot nodule" on the left is large and is over-producing thyroid horomone --- suppressing the TSH.  It over-accumulates Iodine -- suprressing the iodine uptake of the right lobe.  Removal or RAI are the two most common treatment options.  I would opt for removal to be definitive about curing it and making sure there is no small cancer hiding in there -- the comments about psammomatous bodies underscores the subjectivity of these findings -- as these are found in thyroid cancer but are not specific -- it's probably colloid in your case.  Keep us up to date on the pathology findings.