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Residual thryoid tissue after Rai?

A  ultrasound of my neck revealed a 6 x 4mm residual thyroid tissue in the R Bed but no other abnormality.
.In particular this is no pathological lymphadenopathy. Updated blood tests show satisfactory TSH and negative thyroid antibodies..

Had Rai Feb 08 ( 27mci)

I will see my endo again in May

Is it quite normal to have residual thyroid tissue?

TT June 07
3 x pap micro cancers- multifocal
Tg <1


9 Responses
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Avatar universal
I had TT/modified left neck disection in January '08 for pap. carcinoma (with spread to lymph nodes); 250 (yes, 250, not a typo) mCi RAI Feb. '08.  At CT scan for unrelated issue in Sept. '08 revealed a suspicious spot in the thryoid bed.  FNA in Sept. '08 came back positive for papillary cells.  Thyroglobulin during this time went from .12 two months post-surgery to .43 in January '09 (9 months).

PET/CT in May '09 showed nothing in area of the Sept. '08 FNA, but DID show activity in  a lymph node near the left jaw line.  Had a second surgery April '09 to remove suspicious node, as well as any tissue/scar tissue in the original surgical area and the area around the positive FNA.  Path. reports came back negative - no cancer, including the lymph node that showed up on the PET/CT and the area around the FNA in Sept. '08.

BUT, my thyroglobulin continues to go up slowly (.47 now).Oncologist (I now have an oncologist treating me at a cancer hospital, in consult with an endo) is stumped and is consulting with others about next step.  The concensus is that they can't find the cancer, so need to wait until is shows on some sort of scan before deciding on next treatment.  They feel RAI would be pointless, since I had a recurrence after such a high dose of RAI.  We had been talking external beam radiation before the second surgery, but since the cancer couldn't be found, nothing to target.

For now, we're watching and waiting.  Nerve-wracking, but really, we can't treat what we can't find.  Watching my thyroglobulin for any BIG jumps.  Anyone with similar history, please share your treatment plan!
Helpful - 0
947914 tn?1246939805
So glad this was posted. My doc seems to minimize everything (e.g.: I couldn't possibly have cancer...but did), so I was concerned that the body scan showed residual tissue (uptake). He said the radiologist was concerned but he wasn't, that it was typical. He decided that we would watch for growth with an MRI and frequent blood tests.
My take on this? I would MUCH rather go through another surgery than another hypo-hell + RAI session. It will be interesting to keep up on everyone's progress on this forum and see what happens.
Helpful - 0
Avatar universal
I just had the same news.  I have thyroid tissue left in my neck which showed up in the body scan and ultrasound.  My thyroglobulin is negative but I don't feel real confortable with this.  Why can't they just go in and remove that tissue.  I would rather that than wait until it is definalty cancer.
Helpful - 0
Avatar universal
My endo was also very surprised to see that I had some residual thyroid tissue especially after I had TT and Rai 30. He had to double check and do an ultrasound himself and told me that it is caught in a vascular clip. My Tg has always been undectable or <1
I haven't been told my residual tissue isn't a nodule which I am guessing is good news.
But doesn't it mean that residual tissue has like thousand and thousands of cells which could or could not be maligant?
Anyway my endo wants to see me in another year, which I am guessing is good news..
  
Helpful - 0
Avatar universal
I was just looking on the boards to see if anyone had a problem like mine, and I came across your post.  I had an ultrasound today and the radiologist told me there was a 4mm nodule or residual tissue in my thyroid bed.  this is after TT for pap cancer in march 08 and rai 153 in june 08.  my tg has never gone away completely but has been at .3 and .4 for the past six months.  of course, when I heard small nodule I freaked out, as I figured there was nothing left in there by now.  the radiologist told me she wasn't sure what it was, but she did use the word nodule, and said I would need to discuss with the endo.  I have been worried that I would have to do another round of rai b/c of my tg but now I am worried about another potential surgery?  I guess they will want to fna first . . .I just want this to be over.
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Avatar universal
You do a brilliant job of commenting on questions on the thyroid board, how do you do it...

..Unfortunately I don't have the information on the uptake in that area of the thyroid tissue. Would my endo or hospital have that info?
As you said it may well be just be dead tissue, floating around.. Does everyone who have Rai have dead tissue floating around?
How often would you recommend having having an ultrasound and CT scan done as I have nothing scheduled beside endo appointment in May?..

Justin
Helpful - 0
158939 tn?1274915197
The "thyroid tissue" they are seeing may be dead since your Tg is so low.  Did they see any uptake in that area of "thyroid tissue"?  Even 27mCi should have killed "normal" thyroid tissue (which is why I'm saying it may be residual dead tissue) and, if it was cancerous, your Tg would be rising.  The protocol would be to keep an eye on it with ultrasound and CT scans and blood work.
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Avatar universal
Ok.. My Tg hasn't risen as far as I know. The diagnostic staff here say they can't measure the Tg below 1 so everyone thinks that is undetectable..
Anyway that being the case, I guess the RAI wasn't strong enough to kill all the thyroid tissue?
I'm guessing the thyroid tissue is quite normal, if the Tg hasn't risen
Helpful - 0
212753 tn?1275073111
Yes it is normal to have thyroid tissue left behind The thyroid gland is very sticky and try as they may the surgeon cant always get all of the tissue off. That is why it is so important to have The RAI to kill off the tissue left behnd in cancer cases.

Thyroid tissue can also grow back so it is imortant to get your thyroglobin tested to too as it is a marker for cancer. If the TG rises it is a good indication the cancer has returned.
Love Venora
Helpful - 0
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