marsha1975

[marsha1975]

I had a total thyroidectomy on 2/18/08 and I didn't have any problems with the surgery as far as calcium and voice problems go anyway.  I am now 1 week post surgery and I have a massive swelling in my neck which prevents me from being able to straighten my neck in a normal position.  I have to keep my head tilted forward or else I feel like I'm going to rip the stitches out.  I'm pretty sure this is not normal.  My doc's appt is in 2 days to have the sutures removed and I will then discuss my options as to whether I need to get a dose of radiation.  I have seen my biopsy report only because I work in the medical field and had access to the hospital records.  My biopsy report showed papillary carcinoma and says there was no vascular invasion identified but then it says there we're 3 reactive lymph nodes.  Does anyone know what that means?  Does this mean it has spread to the lymph nodes and how would they know that if they did not remove any of the lymph nodes during the surgery.  I know they didn't remove any of the lymph nodes because I have also read the surgery report.  I would like some input on this before my doc's appt so I will know what kind of questions to ask when I go.  Thanks

[marsha1975]

Thanks for your input. I do have a copy of the path report and it reads as follows:  Papillary carcinoma of the thyroid, microcarcinoma (0.5cm).  Tumor is unifocal and is confined to the thyroid parenchyma.  The tumor has a follicular pattern and is encapsulated.  No lymph vascular space invasion identified.  Non-Neoplastic thyroid with multinodular hyperplasia (multinodular goiter).  Three reactive lymph nodes.  AJCC staging: pT1, pN0, pMx.  I also went ahead and got an early doc appt today to check the swelling in my neck and he said it was blood collection but nothing to worry about, which made me feel alot better but I still have to go back on Wed. to have sutures removed and to talk to the doc who did my surgery about my options.  Thanks again and if you have any new input on my pathology report, I would happy to hear from you.

[KJ5854]

I had a total thyroidectomy three weeks ago and I too felt that I had to keep my head tilted forward all the time because when it wasn't forward I would feel pulling in the area of the incision.  I didn't have stitches, I had the Derma-bond glue, but still had that feeling.  I felt like my neck was somewhat swollen but when I returned to my surgeon one week post surgery, he checked it out and said it was fine.  I no longer feel like the swelling is there and my head/neck movement is back to normal.  Have your doctor check this out thoroughly.

Did you get a copy of your path report?  How large was your papilliary carcinoma?  Mine was less than 5mm.  It too showed no vascular invasion.  I had three lymph nodes removed and they showed no cancer.  Are you positive they didn't remove lymph nodes?  My surgeon told me that was standard when thyroid cancer is suspected.  My path report also said "three incidental perithyroid tissue lymph nodes showed reactive hyperplasia.".  

For your doctors appointment tomorrow I would ask him/her to go through the path report line by line.  My path report had a Final Pathologic Diagnosis which gave line by line info on tumor characteristics, tumor site, tumor focality, tumor size, is there tumor encapsulation?, is there capsule invasion?, lymphovascular invasion?, extent of invasion, surgical margin status, blood vessel invasions outside the tumor or in the capsule?, lymph node status and then details on each area of the thyroid and what they found.  Ask the doctor to explain everything to you.  Ask him if lymph nodes were removed.  Make sure to get a copy of your report.  I have looked back at mine countless times.  

I'm not sure that I answered your question, but I hope I helped.  Others on the board can probably give more insight.  

I'm curious as to what size your papilliary cancer was and if you'll be doing RAI.  Because mine was less than 5mm and totally contained I decided along with my endocronologist that I didn't need RAI.  Please keep us posted.   I'm glad to hear you didn't have calcium or voice problems.  I didn't either and feel that was a blessing.