Hello everyone,
I was hoping someone could give me some additional details as to what the next steps in the process would be for me. I had a FNA done a few months ago that came back as "suspicious for cancer". So, I had a TT on 4/14/09. The surgeon told me to think of it as a really big biopsy. Well, as it turns out the first thing he saw when he got in there was a very suspicious looking lymph node. He called a pathologist in right away and he said it was cancerous and to take it out. They then took out my entire thyroid along with 21 other lymph nodes from a central neck compartment disection. I received the path report on Monday and here is what it says:
"Cancer Case Summary Protocol:
THYROID: Resection
MACROSCOPIC:
Specimin Type: Total Thyroidectomy
Tumor Site: Right lobe, left lobe, and isthmus
Tumor Focality: Multifocal.
Tumor Size: Largest nodule is 1.4 cm.
MICROSCOPIC:
Histologic Type: Papillary carcinoma
Pathologic Staging (pTNM):
Primary Tumor (pT) - pT3: Tumor less than 4 cm, but showing minimal extrathyroidal extension (perithyroid soft tissues).
Regional Lymph Nodes (pN) - pN1b: Metastases to bilateral cervical lymph nodes.
Number examined: 21
Number involved: 14
Distant Metastasis (pM): - pMX: Cannot be assessed
Margins: Tumor abuts the inked anterior aspect of the resection.
Venous/Lymphatic (Large/Small Vessell) Invasion (V/L) Present
FINAL DIAGNOSIS:
1. Pretracheal lymph node: Metastatic Papillary Carcinoma
2. Total Tyroidectomy: Multifocal papillary carcinoma (Largest lesion 1.4 cm) extending beyond thyroid capsule, and encroaching inked surgical margin multifocally.
3. Central Neck Compartment, right aspect: Metastatic Papillary Carcinoma in nine of ten lymph nodes.
4. Left aspect of central neck compartment: Metastatic carcinoma in four of ten lymph nodes, normocellular parathyroid tissue noted.
My biggest question is if I am going to need external beam radiation due to the invasion of the lymph nodes. Does anyone know what my next steps are going to be? I have an apt with my endo next week, but would appreciate any thoughts or advice in the meantime. Thanks everyone!