Solitary densely calcified nodule

[sam4305]

Hello Doctor,
I am a 37yo wf. In 11/08 a nodule was found during a MRI after my complaints of trouble swallowing. I was sent for an US. US stated thyroid was normal size, although a solitary shadowing nodule in the medial aspect of the right lobe was found. They requested an AP radiograph of the neck because they wanted to see pattern of calcification in the solitary calcified nodule. "If a thin peripheral rim of calc is present, this would favor a benign adenoma. Internal calc as opposed to periph calc could indicate malignancy."

I had the plain films done and this was the addendum to original US: "Outside plain films of the neck confirm the presence of 8mm calcified soft tissue lesion in right lower neck region that would correspond to the calcified lesion seen on prior US. Calcifications appear to extend throughout the small nodular lesion in question. A densely calcified lesion such as this would not be a good candidate for FNA and, in clinically indicated, surgical excision should be considered."

I spoke with my ENT who recommended surgery, and after my last appt. with him and after his palpitation, he said he didn't want to wait ONE more month to get it out. It is now a year later since my last appt, because I just got ins. back.

All blood test come back negative for thyroid issues. No family thyca that I am aware of, but cancer claims every single person on my mother's side.

So my question is this...in your expert opinion, does this sound like a cancerous nodule, being that it is solitary, densely calcified, and I've also read that Medually typically forms as a this type of nodule and in the same area as mine---the medial aspect and upper right side. I see my ENT again on Mar 8, 2010 and we will be scheduling lobectomy. I feel fine, except that at times I can feel 'tingling' and/or a light 'pulling sensation' on the inside of my neck on the R side.

Thank you for your time.
Stephanie

[Mark Lupo, M.D.]

We can usually do FNA biopsy of almost any thyroid nodule.  Sometimes those with dense calcification are difficult to FNA and we do elect surgery.
Most of these are benign, but you do need a definite answer.  So if the opinion is that it is not able to undergo US guided FNA, then removal would provide a definite answer.

[sam4305]

My ENT also found a cyst under my tongue that he will drain during surgery, he also stated it is not large enough to warrant dysphagia. My primary physician basically told me it's in my head...this was before the nodule was even discovered. I have been tested for myasthenia gravis and MS. I had some issues last year including IBS, acid reflux, urine retention, and pre-cancerous cells found on my cervix, fatigue, depression, anxiety, tinnitus, and a huge pressure feeling in my neck...like I was blowing up on the inside and being choked at the same time. I haven't had any troubles for quite some time, I believe it was stress. I have not been tested for lupus.