Recently diagnosed

[arress]

with a nodule on my thyroid. Had a fine needle biopsy, which came back inconclusive. Had a TSH blood work but no information back on that as of yet..

Was sent to a general surgeon who now states that it needs to be removed.  I do at times have trouble with swallowing. But does this warrant the removal of my thryoid? I would prefer the non-surgical approaches if at all possible. But when I asked if there was another treatment available she said just another biopsy and or surgery.

Should I wait out the results of the blood work? Would I be fine trying a thyroid medication and or the radiation?

[arress]

Just to update.
Findings: The left thyroid lobe is normal siz, measuring 4.5x1.5x1.5. The right thyroid lobe is enlarged, measuring 4.6x2.5x2.5 Cm. A complex systic mass is present within the right thyroid lobe in the midportion of the lobe,measuring 2.3 in maximal diameter, with a solid nodular component arising from the wall of this lesion. The solid component measures approximately 13mm in diameter. This correlates with one of the areas of palpable concern. A smaller benign-appearing nodule is also identified in the right thyroid lobe, measuring 5 mm in diameter and possibly correlating with the other area of palpable concern. The left thyroid love is homogeneous and normal in echotexture. No left thryroid nodule is identified.
Impression:
A complex cystic mass with a solid nodule is identified in the thryoid lobe, correlating with one of the areas of palpable concern. Malignancy must be considered. Tissue diagnosis is recommended.

Small benign.appearing right thryoid nodule,possibly correlation with the other palpable lump. This can be followed with a repeat ultrasound of the thyroid in one year.

GP recommends having it removed. Seems resistant to another FNA . His response was if that came back inconclusive, how will  you sleep at night. Well why isn't there a more accurate way of testing? It appears to me that some unneeded surgeries happen due to the fact that they (biopsies) don't shed enough light on whether it truly is cancer, or a benign cyst. How frustrating to know that basically it is a shot in the dark unless you have the area of concern removed. Then taken and tested. So upsetting and frustrating!
  I will have to call insurance company as he was somewhat unwilling to refer me to an endro. Not sure what direction I will turn to .

[arress]

Called on labwork. It appears to be within normal range. Appt. to see GP is next week. I will ask if they ran blood work for  Hashimoto. Is there another screen I should have them  look into with this next set of blood work?
I will get the full results and post that at that time.

[Barb135]

I don't think you're going to get around a surgery, especially, if they can't get an FNA to conclusively rule a cancer. I can't imagine that you'd not want a surgery if there's a possibility there may be cancer; to my knowledge the only treatment for thyroid cancer is removal of the thyroid.

You would have to make sure any anesthesiologist is aware of your sensitivity to anesthesia.  They are trained to deal with all types of situations.

Since you don't have blood work to confirm/rule out Hashimoto's, it's hard to say about the RA, except that both RA and Hashi are autoimmune diseases and if a person gets one autoimmune, the chances are high that person would get another one or more autoimmune.  

[arress]

I wanted to add I have RA and was wondering what if any role this may play with my thyroid issues?

[arress]

Thanks Beth. Basically she said that my two options were removal or another biopsy. Nothing was scheduled as I need time to heal from the first biopsy. My neck is still sore and completely black and blue.

But she did mention that another FNA would likely just return the same results. And the only real way to know would be during the surgery when it could be removed and tested.

I have extreme sensitivity to anesthesia, which is cause for concern with any surgery I would undergo. Yet one more reason for me to lean toward a non-surgical route. My question is ...is it possible to treat this without surgery?  

[Barb135]

Do you have a repeat FNA scheduled, as recommended in this report?  

The report states: "Focal changes raise the possibility of papillary thyroid carcinoma".  This may be what your surgeon is basing his/her recommendation on.  Thyroid cancer is highly curable, when caught early, but it does require thyroid removal.  

You could try for a second opinion, but I wouldn't delay; any time cancer is a possibility, it should thoroughly checked out asap.  

It doesn't take long to actually run the blood work, but with the Holiday, you may not get it back right away.  I'd be on the phone first thing tomorrow asking the doctor about it.

Your symptoms indicate hypothyroidism and possibly Hashimoto's.

[arress]

Yes...Hard, cystic 1 ML is what the report is stating in terms of size and density. Bloodwork has not returned as of yet. A TSH screening was run.. Not sure if Graves or Hashimoto's was tested for. I have had symptoms that include unusual weight gain. Always feeling drained. It seems to be interfering with my ability to think clearly. At times I have difficulty with swallowing but not often.
I will continue to update as more info comes my way. I was completely taken by surprise by the lump...As it wasn't visible until just recently. And was found due to me having pneumonia.

Diagnosis Cytologic Findings
Specimen Adequacy- Satisfactory but limited by, low epithellal cellularity. Cellular degeneration.

Comments:
This thyroid FNA specimen is extremely low in epithellal cellularity. It contains a single group of mildly atypical, but degenerat follcular cells, a few of which appear to contain intranuclear cytoplasmic inclusions. Well developed nuclear grooves are not identified. Otherwise, the specimen contains scant colloid, histiocytes, pieces of skeltal muscle and blood. Focal changes raise the possibility of papillary thyroid carcinoma, but the specimen is of borderline adequacy in terms of epithellal cellularity and cellular preservation. Suggest repeat FNA of the thyroid, especially if this is a clinically or radiographically suspicious lesion.

[Barb135]

Without blood test results and more information on the nodule, it's impossible for us to give any advice.

Do you know how big the nodule was? Do you have the actual report from the biopsy?

Was TSH the only other blood work done?  I'd specifically like to see blood tests for Free T3 and Free T4.  Have you previously been diagnosed with a thyroid condition? Do you have symptoms of a thyroid condition - either hyper or hypo? If so, which symptoms?  Have you been tested for an autoimmune thyroid disease - either Graves or Hashimoto's (or both)?

Many of us have nodules on our thyroid and they aren't a cause for concern.  Likewise, thyroid removal is usually not done for nodules unless they are causing specific problems, such as swallowing, if they are cancerous, if you have Graves Disease, etc.

Thyroid removal seems a bit premature for an inconclusive nodule, but there's too much information we don't have.  If you can give us more information, we'll certainly try to help guide you.

You should always get a copy of all blood test results, as well as copies of the imaging reports or other information, for your records. In the U.S, doctors are required, by law, to provide a copy, upon request.