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PTC-Bone Metastasis?
Hi Dr,
I've been suffering with Left shoulder,scapula,clavicle pain for about a year. The pain radiates down my left forearm. The pain is really bad at night and my husband rubs my left shoulder/scapula every single night. Saw an Ortho Dr who suggested bursitis and I've had 2 cortisone injections with each one relieving the pain for a month or so. I've also had shortness of breath for about 6 months (42 yrs old this month).
Recent cervical spine MRI shows:Multilevel Spondylotic changes worse at the C4-5 level. (Central canal and foraminal stenosis).
I was diagnosed with PTC and had a TT 10/3/08. Path report : Solitary 1.4cm left nodule PTC. Margines:Negative Angiolymphatic invasion:Not identified Lymph Nodes: Metastatic Carcinoma to 9 of 12 lymph nodes (Level VI and VII). TNM Classification: pT1, pN1, pMX. I am on a LID awaiting WBS.
What concerns me the most is that I had positive nodes in Level VI and VII and level VII in located in the mediastinal area (not part of the neck right?)
My Dr states the paratracheal and mediastinal nodes are considered the Regional Lymph Nodes and those are taken out during the Central Compartment Dissection (which I had at the time of the TT) and is routine during TT.
Dr, I have 3 questions: :)
Does positive Level VI and VII nodes mean a poorer prognosis in PTC?
Is there a chance the cancer has metastasised to my shoulder/clavicle and lungs?
Does METASTATIC CARCINOMA to 9 out of 12 lymph nodes mean the cancer has spread BEYOND those nodes?
Thank you for your time and advice,
Verona
I've been suffering with Left shoulder,scapula,clavicle pain for about a year. The pain radiates down my left forearm. The pain is really bad at night and my husband rubs my left shoulder/scapula every single night. Saw an Ortho Dr who suggested bursitis and I've had 2 cortisone injections with each one relieving the pain for a month or so. I've also had shortness of breath for about 6 months (42 yrs old this month).
Recent cervical spine MRI shows:Multilevel Spondylotic changes worse at the C4-5 level. (Central canal and foraminal stenosis).
I was diagnosed with PTC and had a TT 10/3/08. Path report : Solitary 1.4cm left nodule PTC. Margines:Negative Angiolymphatic invasion:Not identified Lymph Nodes: Metastatic Carcinoma to 9 of 12 lymph nodes (Level VI and VII). TNM Classification: pT1, pN1, pMX. I am on a LID awaiting WBS.
What concerns me the most is that I had positive nodes in Level VI and VII and level VII in located in the mediastinal area (not part of the neck right?)
My Dr states the paratracheal and mediastinal nodes are considered the Regional Lymph Nodes and those are taken out during the Central Compartment Dissection (which I had at the time of the TT) and is routine during TT.
Dr, I have 3 questions: :)
Does positive Level VI and VII nodes mean a poorer prognosis in PTC?
Is there a chance the cancer has metastasised to my shoulder/clavicle and lungs?
Does METASTATIC CARCINOMA to 9 out of 12 lymph nodes mean the cancer has spread BEYOND those nodes?
Thank you for your time and advice,
Verona
MEDICAL PROFESSIONAL
You have a stage I papillary thyroid cancer. Central compartment involvment is fairly common (level VI and VII) and at your age does not change the overall excellent prognosis. RAI treatment is indicated. The chance of spread to the shoulder/clavicle area is very low. The post treatment WBS will help verify there is no spread outside the neck area, but the chance is low.
I've not been fully staged as of yet because I've not had the WBS (on LID now). The (pM) part of the staging will be done after WBS. :)
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