Thyroid nodule 4.6

[marfa]

I have a nodule on the left side of my thyroid, the last scan reveals that it is 4.6cm. My blood tests show that my thyroid isn't affected.The doc says i have to have it operated together with the left side (lobe) of my thyroid and after this i'd have to take med for life. Also he says its a "cold" nodule.

Isn't there any other treatment i can have rather than op? And why do they have to extract all the left side of my thyroid instead of just the nodule???

I'd really appreciate your reply since i'm very worried since i'm told that i can't leave it for long and i really don't know why if (i've understood correctly) most nodules are benign? what happens if idon't operate? thankyou in advance

[Debb1958]

I found a swollen lymph node in the left side of my neck/collarbone area about a year ago. This happened after having Lap Band surgery about 6 months before.  This may or may not have anything to do with it but felt the fact that I am losing weight should be mentioned due to that probably being one of the reasons I felt the lump in the first place and not really sure when this swollen lymph node first appeared. Starting weight 296lbs, now 235lbs.

The swollen node was the size of a hot tamale candy and had the same texture. Bloodwork found that I had mono. A sonagram found that there were two swollen lymph nodes on the left side of my neck/collarbone about the same size and three nodules were found on my thyroid. A 4cm sized one on the right side and two smaller ones on the left side of my thyroid, measuring 1cm or less. They cannot feel the nodules by touch.

The mono went away about 6 months later but the lymph nodes are still swollen. To me they feel as though they move back and forth between my neck and the collarbone and at times have bunched together and get to be the size of a small apricot, flat, hard and oval shaped then back to the smaller size.

Fine Needle Biospies were performed and no cancerous cells were found. My bloodwork is coming out normal as far as cell count and thyroid levels.

The thyroid nodules have not grown but I feel as though I constantly have a tight turtleneck sweater on and have issues with breathing while laying down. I feel a choking sensation at times and have feelings of pressure, pulling and pinching in sides my neck.

Other symptoms that may be connected are sweating then severe chilling after the sweats (from sweat soaked clothing?), extreme fatigue and anxiety, high blood pressure and mood swings (some of these symptoms could be related to the fact that I am no longer taking premarin due to fears of being high risk for breast cancer. I haven't been on premarin for several years now.  I'm seeing a GYN for this next week to see if I can get help there.

Past surgeries: appendix - 1968, cyst on tailbone - 1977, gall bladder - 1979 ( one month after first child was born), tubal ligation - 1985 (after second child was born), 1989 - exploritory lap (looking for endometriosis, not found), 1996 - bladder tie up/uterus removal (found endometriosis, total hysterectomy performed), Low back surgery (L5/S1 fusion) - 2003, Low back surgery (L4/L5 partial disectomy) - 2005, Lap Band Surgery - 2007

A sleep study was performed and was I was found to be breathing at at O2 level of 75% more than once an hour during a four hour sleep. It was thought that I needed a C-Pap with supplemental O2. The second half of the study found the C-Pap would do the job without need for supplemental O2.

Went to see my surgeon yesterday, first time. She wants to remove all my thyroid and at least 1 lymph node.  I am scheduled for surgery on May 14th but I really need to do some soul searching before then.

With my family history (Mom having had Leukemia twice, breast cancer and melanoma, 2 of her sisters having cancer - 1 breast, 1 lung, her Dad having died of bone cancer and my brother dying of kidney cancer) they are concerned on what they will find when they get in there and feel that more surgeries may be needed in the future. So take it all now and hope for the best or let them cut and do pathology while I'm under, seeing if theres cancer as we go, which could lead up to 3 if not more surgeries.

I need to add that I am Type 2 Diabetic on 2000mgs of Metformin a day.

Any suggestions would be helpful from those that have been through this or may know something about what could be going on and if I should go through with the all or partial removal of my thyroid and swollen noids.

Thank you, Debb

[Mark Lupo, M.D.]

If it is not bothering you and FNA biopsy is benign (would consider 2 separate biopsies about 3-4 months apart), then you don't necessarily need surgery.  Some use 4cm as cut-off for referring to surgery.  We take the whole side out as it helps with the diagnosis and has become the procedure of choice over removing the nodule only.  However, if the right side remains there is only a 30% chance that you would need thyroid meds.