swelling under left ear after thyroid cancer treatment

[bellepatty]

I just noticed a swelling under my left ear.  On June 11, I had a large (6 cm)cystic structure removed from left side of neck. I am 50 years old and female.  It turned out to be thyroid cancer (papillary), so on June 17 I had a total thyroidectomy.   On July 31, I had RAI treatment (200 mcl).  The cancer removed on the left side may have been "nodal" in nature, but the doctor did not suspect cancer at that time and did not remove a lot of lymph nodes.  The swelling is not painful, but the left side is definitely bigger than the right side of my neck.  Is this likely a cancerous lymph node?   Should I see my local doctor who did the surgeries (ENT).  After RAI at a nearby hospital, I saw a radiologist at a teaching hospital one time so that he could read the scan taken after RAI.  He had me make an appointment with an endocrinologist associated with him.  I don't have an ENT at the teaching hospital. (Note: the radiologist at the nearby hospital did not seem to know anything about a low iodine diet and administered the RAI without asking me questions about recent scans.  I had a CAT scan just before the surgery in June.  I learned from my own research later that the RAI should have likely been later to avoid the problem of iodine in the contrast medium from the CAT scan, so I'm concerned about the effectiveness of the RAI).  The scan did show quite a bit of uptake on the left side of my neck.  When should a follow-up scan be done?  What kind of scan?  Which doctor should I see?
Thanks

[nissah46]

Is the swelling on your jawline? If so, it may be blocked salivary glands, which happens as a result of RAI.  I had it on one side, then the other, then both.  It helps to massage and put on warm compress.  
Trish

[utahmomma]

See an endocrinologist who specializes in thyroid conditions.  You need to have your TSH and thyroglobulin (Tg) checked - those are both indicators of ongoing or recurrent thyroid cancer.  At this point your Tg should be undetectable or at least below 0.02 - any higher and there is a chance that you still have papillary carcinoma.

Yes, the contrast from the CT scan may have compromised the success of the RAI so you may be looking at another dose if the Tg is elevated.

A CT may be helpful but will not tell, conclusively, whether it is cancer or not.  With the recent surgery and all of the iodine it could just be a swollen gland but with the increased uptake in that area it's not worth "wait and see"

It's difficult to find a good thyroid specialist but you really need one.  It may not hurt to talk to an oncologist too (many disregard thyroid cancers so find one who will take on your case).

Please take care


Utahmomma
papillary carcinoma '03, followup surgery '04
recurrence and RAI '06 and probably next month too
three sisters with papillary carcinoma (one with three recurrences/RAI and distant metastases)
one sister with precancerous thyroid
daughter with precancerous thyroid