Solid 2.9x1.9cm solid hypoechoic nodule found

[cocomadam]

Hi, I'm hoping someone can help me or give me some insight, as I am extremely stressed.

Lately I have been feeling "unwell", I am pale, exhausted, agitated and suffering from anxiety. It is effecting my work. I went to my GP, who found a large solid mass on the right side of my neck. I was sent for an Ultrasound which revealed an "enlarged right lobe of the thyroid, a 2.9x1.9cm vascular solid hypoechoic nodule on the right side, plus 2 3mm nodules on the left side" It says the large nodule is "homeogenous in texture". I am a 24 year old female, and naturally, I am freaking out! I have noticed that my throat feels right, sore and dry all the time. The GP said the nodule needed an FNA, and I am scheduled to see a surgeon soon.

All my blood test results came back normal, including my Thyroid function tests. The report said my thyroid was functioning normally. My question is, is this something to be worried about? I am extremely anxious, lethargic, sensitive to light and feeling like something is wrong. My GP says my age is on my side, but some young random people do get cancer. Does my nodule sound malignant, especially the size, my symptoms, and the fact my thyroid is operating normally?

I'm sorry for the long post, I really really appreciate your time,
Kelly.

[MANmom]

Sorry to hear about the diagnosis, I feel your pain...I had the same, the first surgery they did find several small foci of papillary cancer.  My Endo told me that I could leave the other side (with a 1.6 cm nodule) in place, but the surgeons (3) all said remove the other side.  I too, had a normally functioning thyroid, but I did test positive for hashimoto's disease.  In my case, I am 45, and with hashi's diagnosis, I knew my thyroid would eventually stop working.  So I took out the other side, turns out that was where the big tumor was, pretty much the whole nodule was tumor...1.5 cm.  I am glad I took out the other side.  Yes, I had reservations about taking out the other side, but many people live just fine without a thyroid, some are even born without one.  I was dosed with RAI in July, and after 7 months of treatment with levothyroxin, I feel pretty normal.  I know you are much younger.  The fact is that thyroid cancer is a very slow growing cancer, and it usually does not metastasize, so watching and waiting is OK if you don't choose to have it removed.  You can wait and see if the nodules get bigger, then make a decision later.  Time is on your side, and no two people are alike in the thyroid disfunction world...good luck with your decision.

[cocomadam]

Update:

I had my partial thyroidectomy on April 12th.  I had a complication where I had a post operative hematoma and was unable to breathe. I required emergency surgery to fix this.

Today I saw my surgeon and got my histopathology report.  It has identified that I have minimally invasive follicular carcinoma aka cancer.  I cried instantly when I was told this and have never been so shocked in my life.  My surgeon, who is actually a breast surgeon was also equally as shocked.

My issue is that he told me I require no further treatment, just checks every 6 months as he removed the half of my thyroid with my cancer.  This seems unsettling to me, as from what I have read, a diagnosis of follicular cancer is grounds for a total thyroidectomy and radio-iodine treatment.  He says I do not need this, even though I have 2 small nodules growing on the left side.  I read on a website that a surgeon who says a total thyroidectomy is not needed is uncomfortable doing the surgery.  I am getting a second opinion with an endocrine surgeon.

I am wondering if my surgeon is hesitant to more surgery because of respiratory problems I had after surgery, and my hematoma.  I am scared to have surgery again as I felt close to death, but I don't want to leave cancer in my body.

Please any advise????

[Kimmydee2]

I have Hashimoto's diagnosed by biopsy of nodule 12 year ago.  This nodule at first was under 1.0 cm in size.  My Labs are always within normal limits except elevated TPOab.  Since last summer I have started having dizzy spells, extreme fatigue and weight loss of about 50 pounds.  My labs are still normal.  This last u/s March 2010 my thyroid and nodules are considerably larger than previous three years ago.  The isthmus measures 5mm.  The right thyroid measures 7.3 x 2.2 x 2.1 cm.  The left thyroid measures 5.2 x 1.2 x 1.5 cm.  There is an inferior pole heterogeneous right isoechoic thyroid nodule measuring 2.6 x 2.5 x 1.7 cm with multiple cysts.  There are two new nodules on the left lobes 4 x 5 x 3 mm in size.  The impression was 2.6 cm right solid heterogeneous thyroid mass.  I have my FNA on 4-9-10.  I was supposed to follow up on this three years ago and let it go after my last FNA because I didn't have health insurance.  My last FNA showed suspicious cells with Hashimoto's.  I will keep all of you posted on my results.

[MANmom]

All my thyroid tests were normal except my TPOab, which meant I had hashimotos, I had four nodules, and I had cancer.  Get the FNA biopsy, it may answer your question, but it may not.  The fact that the right lobe has a solid (fluid would not be cancerous), vascular (cancer needs blood supply) nodule that is large needs to be checked.  Luckily, if it is cancer, it is VERY curable.  I believe your chances of cancer with this information are about 15%.  This also runs in families, so if there is thyroid disease in the family, your chances are probably higher.  I had my sister tested after my diagnosis, she had the same cancer, my other sister is in the process of testing, she, too, also has nodules.  Two of my brothers have Hashimotos, as did my Dad.

[alona99]

I would urge you have the FNA done considering everthing, but from what I understand especially the vascular, solid hypoechoic information. Just my opinion. Blessings!

[cocomadam]

Sorry,
I had a FBE (full blood examination) all in normal limits. White cell count was 5.8(4.0-11.0).
A glucose serum test was done, I fasted from 10pm and had the test done at 11:00am. Result was 5.8mmol/L (4.0-6.0). Cholesterol was normal, at 4.2mmol/L. Iron came back 13umol/L (7-27).

Thyroid function test (TSH): 1.19mIU/L.
Ultrasound result reads:

The right lobe is marginally enlarged measuring 6.2 x 1.4 x 2cm the left 4.5 x 1.4 x 1.7 cm. Isthmus 28 x 4mm, No retrosternal extension. Lobes are homogeneous in texture. There is a single vascular solid hypoechoic nodule, 2.9x1.9cm, within the lower third of the right lobe extending into the isthmus medially. There are two small nodules seen within the left, a 4mm upper pole nodule and 3mm lower pole nodule.

Comment: The right lobe is marginally enlarged. There is a vascular solid hypoechoic nodule, present within the lower third of the right love of the thyroid gland extending medially into the isthmus measuring 2.9x1.9cm FNA of this is recommended.

Thanks,
Kelly.

[Super_sally888]

Please let us know exactly what blood tests were done and what the reference ranges were for the results.  That will let us comment better.

Yes, age is on your side in terms of thyroid cancer.  But they do need to get to the bottom of what is going on, as something is.