Thyroid Nodules

[Mucka]

I have developd a solid mass/nodule (5.7x2.7x3.7 on last u/s which grew from initial one six days previous at 4.3xx2x2.6) with calcification taking up pretty much my whole left thyroid lobe.  I have three other small ones also, though, those were not biospied. From the times these tests were done it was only 3 weeks since I noticed the lump. The biopsy came back benign but with follicular cells within it with the pathologist stating further investigation is warranted pending clinical appearance./symptoms.  My Internist had sent me to a surgeon urgently for a surgical consult for removal of my thyroid gland and the ENT surgeon was hesitant and wanted to wait a month as he thought I had acute thyroiditis.  My Internist very much disagreed.  I have had 2 ultrasounds, 1 CT scan w/contrast and now this week I am having a thyroid uptake to determine if it is a hot/cold/warm nodule.  My Internist's office had called last Friday and stated that when they retrieve the results of this scan they want to see me regarding seeking consultation from an Endocrinology Surgeon in another province (we don't have one).  I am not treated with any medications either.

Now my questions: Could it be cancer even if it is a hot nodule?  Is calcification that bad and does it always lead to cancer?  If the occurance is rapid does this lean towards cancer?  Can an FNA determine noncancer/cancer follicular cells?  

I know it is a lot of questions, but I just want to have some sort of sense before going back to the Internist.

[kimmi292]

I dont know if we anything in  common, but I found your case interesting cause Thyroiditus has never been mentioned to me and I only saw an endo once right before he sent me to the surgeon. This was 2 and a half yrs. ago. I had cold nodules all over my left Lobe and a very large goiter right in the middle of my neck, couldn't swallow very well ,I lost alot of weight cause i wouldn't eat after choking on meat & breads a couple of times. They put me on Xanax for panick attacks it was scarring the hell out of me thought I was gonna choke to death. my blood levels were all normal. No Hypo or Hyper. Surgeonn removed left lobe & the goiter. Last weei had a new Ultrasound. It showed my left thyroid is 7.5x2.1x1.7 and is enlarged. On the medial side there is a mass measuring 2.2x1.9x1.7 and a cyst and a nodule and the enlogated part has calcification. My surgeon says it makes no sense cause he removed the left side. So he's sending me for a new ultrasound and a thyroid scan the nuclear one.I have to wait 3 weeks. this freaks me out a bit cause that sounds so big and it doesny make sense and its starting to hurt a little. This thyroid business really stinks. I'm sorry for your troubles. I hope all works out well for you.

[Mark Lupo, M.D.]

Follicular cells are normal thyroid cells. The scan may be difficult to interpret with the recent contrasted-CT (iodine load)...but if clearly a hot nodule, less likely cancer.  Calcification may mean long-standing nodule, but some calcification patterns are suspicious.

The growth may mean some bleeding into the nodule -- which does happen commonly.  Without significant pain and lab abnormalities, this is not likely a (sub)acute thyroiditis. - it's certainly not an acute thyroiditis (that is a severe infection and not subtle).

A specialist is a good next step as removal may be the best option especially if there is anything suspicious on second opinion of the FNA biopsy (which the specialist will want) or if you have any compressive symptoms.

[kathyMMM]

With all that is going on it sounds like you should be on thyroid meds after surgery, which sounds like where you are heading.  (It really wasn't that bad.)  Google side effects of Synthroid and also Armour in case you have to be on meds  - this way you will be more informed about these two leading drugs.

[kathyMMM]

How can it be benign but with follicular cells - aren't follicular cells cancer?   I would look that up on the internet and do whatever  I needed to do to get those things out of there!  To me it is always better to be safe than sorry.  I wish I had that option - but my papillary thyroid cancer had already invaded 2/3 of my lymph nodes by the time I knew it.  Don't take a chance with your life!  Do preventive steps if you can!