Worried about recent CT neck scan results and fatgue

[vanvechten]

After learning that I have a 3cm goiter on right thyroid and having a FNB that showed it's probably benign, I started experencing increased neck pain, difficulty swallowing and "fatty tissue-like"growths at the neck line on both sides.  I had a CT scan with contrast.  In addition to the radiologist's "impresson"  showing what I know about the goiter in the thryoid, the report also says, "mild cervical lymphadenopathy, largest at level 4 in the left lower neck.  This node has abnormal morphology, possibly due to reactive or metastic lymphadenopathy." My thyroid functions are normal.  I am experiencing immense fatigue that began months ago, but is worsening to the point of my taking a leave from work. The ENT is going to remove the right thyroid and immediately test for any cancer, at which time she then will remove it all.  What is your impression? She says I'm symptomatic for cancer.  It's the last statement that worries me: M. Lymph....  If cancer, could it have spread elsewhere and will she know it?Thanks for your advice.

[vanvechten]

You are a fabulous resource to worried folks like me!  Thank you!  And I appreciate your not answering my "1-10" question exactly like that. P.S.I was told and have read that the thryroid supplies hormones  to the female organs, which happen to be the easiest place in the body for cancer cells to grow. Again, my thanks, and God Bless.

[utahmomma]

I'm no medical expert - just an expert patient I guess.

Okay, here are the things that you posted that make me concerned about it being cancer:
- 3cm (very large size)
- difficulty swallowing
- "growths on the neck lines on both sides"
- the radiologist saying the lymph node: "has abnormal morphology, possibly due to reactive or metastatic lymphadenopathy"
- normal thyroid labs
- your fatigue

All of those are worrisome - especially the size of the nodule, the normal labs, and the CT report on the lymph node.  I don't know what to tell you on a scale of 1-10 because they will not know for sure until they actually remove the thyroid and biopsy it.  Even my own endo thought his nodule looked cancerous but was actually benign.  Let's just say that you have a pretty good chance that it's going to need further treatment.

My youngest sister's was confined just to the thyroid and one lymph node.  They were shocked that it metastasized to her stomach, liver, and breasts.   I had the smallest amount of cancer (5mm) yet I had a recurrence and two of my other sisters never have.  You just never know until they determine *if* it's cancerous or not; what type of cancer it is; where it may be; etc.

The *good* thing about the two major types of thyroid cancer is they are easy to locate and treat because they absorb iodine so they just radiate iodine and target the cancer cells - unlike chemo that kills off all of the healthy cells in your body too.

Oh . . . and about your visit with the GYN.  Many, many of us thyroid patients also have poly-cystic ovarian disease, fibrocystic breast disease, gallbladder problems, and Type II diabetes.  Don't' ask me why - something with the endocrine systems going nuts.  The "thickening" your GYN found may be related to poly-cystic ovarian disease.  (I had to have both of my ovaries removed because they kept growing cysts too).

Ain't DNA just a blast?!?!  :-(

[vanvechten]

I  appreciate your taking the timeto shareyour experience. One follow up question. Was your young sister's spreading of the cancer related to the initial finding of the spread to the lymph nodes?  I saw the gyn on Friday-from the initial exam alone, my left side near ovaries is "thicker" than the right.She is consulting a colleague since she is a nurse practioner. Might explain my vague nausea after meals, gas, and lowerpelvic and back pain. You seem both experienced and knowledgable.  I would appreciate the following answer:  On a "cancer probablity" scale of 1-10, where would put me?  (10 high chance.)  HONESTLY!

[vanvechten]

I don't know those results.  Many thanks for your response, though.

[TamraW]

Utahmamma has good advice.

Also, I must ask, what are 'normal' levels? I went through this with a few endos before I discovered that my TSH of 2.74 was actually not normal. Any TSH over 2.0 is worth a second look if hypo symptoms accompany the normal/high TSH.

Do you have FT3, FT4, TSH, TGab and TPOab blood results?

Please post them.

Take care...
:) Tamra

[utahmomma]

Can't tell you what to do but can share my story.

I was pretty much in a similar situation except for I saw the nasty nodule on my ultrasound results, did some research on the "complex nodule" and the fact it had sharp, irregular edges, and decided to get it out.  My surgeon also agreed to have a pathologist in the OR and do a "frozen cut-down" while I was in the OR - if cancer was found they were to take the entire thyroid (not just the right lobe where the nodules were).  They did cut into the right lobe and didn't find cancer so I was closed up and sent to the recovery room.  While I was in recovery the pathologist continued to dissect the lobe and found a 5mm area of cancer.  Okay, it was out and no nodules on the left side so no problem, right?!?!

Over the next 12 months three of my four sisters were also diagnosed with papillary carcinoma (full TTs), the other sister with precancerous nodules (full TT for her) and my 16 year old daughter with precancerous nodules (full TT too - and one nodule was compressing her jugular).   The youngest sister had the cancer spread into her lymph nodes so she had a complete neck dissection (all lymph nodes removed).   (Oh, and two of the sisters with cancer had "benign" biopsies.)

Exactly one year after the first surgery I had the left lobe removed - which was benign.  I'm so glad that I did because two years after that I had a recurrence and would not have been able to have the radioactive iodine treatment (RAI or I-131) if I still had half of my thyroid.

The youngest sister had her cancer spread to her breasts, stomach, and liver (they can easily find it with radioactive iodine scans - thyroid tissue absorbs iodine).  She needed 3 RAI treatments but is now 100% cancer free and has had two beautiful daughters since then.

If it looks like it is cancer *at all*, please talk to your surgeon about getting the entire thing out - especially since there is a suspicious lymph node.

Just my experience.

Utahmomma
the cancerous one