large nodule "most unusual mass"

[mgmon]

hi,

I'm a 48 year old woman, and had a chest ct for chest pain (still have pain, but chest ct was clear).........except.......my dr. saw a small nodule on my thyroid, so I had a thyroid ultrasound and 123 uptake.  My dr. indicated there were 2 nodules on left side, 3 on right side, and he wanted a fine needle biopsy of one, as it was large (4.24 cm).

I just had the biopsy, and now have to wait for the results.  The hospital gave me the disk and reports from the imaging associates, so I am able to read their report, which is why I'm so scared now.  This is some of what was written:  "Occupying almost the entire left thyroid lobe is a most unusual mass"  it is 4.24x1.29x1.93 cm.  Its center contains a branched water density structure.  There are linear water density markings that radiate through the echogenic solid tissue at the periphery.  The solid tissue is less echogenic than adjacent thyroid.  There is abundant peripheral vascularity and superficial vascularity.  Conclusion:  Various thyroid nodules with the appearance of follicular cysts.  Most unusual mass in the left thyroid lobe occupying most of its volume".  The uptake study report says: "24 hour uptake is 27.9% which is within normal range.  Uptake is 11.6 percent and is measured at 16.7 percent in the left lobe.  The static images show multiple areas of defect.  Ultrasound shows multiple bilateral thyroid nodules.  The static images show a focal area of decreased activity in the mid left lobe corresponding to the large mass seen in this area on ultrasound.  Impression:  The static images show multiple areas of decreased activity bilaterally.  Ultrasound shows bilateral thyroid nodules".    Can this 'most unusual mass" be benign, or does it sound worse, especially because of its size?  I had no symptoms of a problem with my thyroid.......I've read that being over 45 and having a nodule greater than 4cm just isn't good.  What about the follicular cysts along with the large nodule....does this make it any more or less likely to be a benign condition?  thanks so much,  mary

[mgmon]

thanks to you both for your replies.  It does help to hear words of encouragement from others. The waiting is indescribably hard as you know.  Why do you have to wait three weeks for your surgery?  Were your biopsy results inconclusive?

[katebrunk]

Based on the description, it sounds like a large cystic mass; likely marked as unusual due to it's size and vascular appearance.  It is not incredibly unusual to have many nodules, I have more than can be counted with 2 larger dominant nodules, one in each lobe of 3 cm in the left and 2 cm in the right.  The discomfort alone means that a number of courses of action are likely to be taken, at the very least, if the large unusual mass is in fact cystic it will be drained.  With the number of nodules and any signs of rapid growth or concerns with the vascular nature of the largest nodule, they will likely look to remove your thyroid or the lobe in which it is contained.  The results of your biopsy will tell them more but, with such a large mass intervention is quite likely needed.  Even if the diagnosis is malignant, survival rates are incredibly high.  The likelyhood of the toughest fight is slim!!!  Research tells us that the doctors don't know a whole lot....but, they are learning more.  Thyroid cancer is slow growing, which is also positive.  Despite that, I can completely understand your worry....I went through it and am still going through it.  
I am  having a total thyroidectomy in 3 weeks and won't have full answers on malignancy until then; even with a fine needle biopsy of one of the larger nodules.  Keep a positive attitude, ask the doctor every question you can think of, insist on getting to answers quickly!  Good luck and keep us posted!

[ChitChatNine]

Hi, my SIL had a huge one removed (total of about 9.0 cm's for the two of them) and was totally benign and totally over 40 by a lot!    I'm not sure and not a Dr., but you can try to post on Dr. Lupo's forum, too.

WELCOME~