# Thyroid Nodule...Thoughts opinions anyone?



## CLRRN (Jun 22, 2011)

Hi Everyone,

So I've seen the medical experts so now I'm coming to you, the experts with real life experiences.

I noticed that I was feeling a "weird" sensation when I swallowed, ear fullness/pain, occasional sore throat and sometimes felt like I was choking on food. It was intermittent but at times felt like that were something in my throat. Initially I thought it was me being paranoid because my partner is 13 months post treatment for Head/Neck Cancer (Stage 4 Tonsil) so I swallow ALL the time (consciously) and always feel my neck.

To date my thyroid labs are normal however on exam, the doctor felt "fullness in my neck". I had a thyroid ultrasound and it showed a 3.2 cm nodule on the left and multiple nodules on the right (6mm, 5mm and 1mm). I also had an FNA and here are the results:

"The specimen is moderately cellular and could represent a cellular adenomatoid nodule but the presence of microfollicle formation, monolayered sheets of equal sized cohesive cells, scant colloid and occasional dense round 'colloid bodies' raise the possibility of a neoplasm. Excision of the lesion for definitive diagnosis is recommended as clinically indicated"

I met with the ENT whose practice specializes in Thyroid and I'm moving forward to have a partial thryroidectomy with the understanding if the final path comes back malignant, I will need to go back and have a TT.

Just wanted to see if any of you in this group had (or has) a similar experience and would like to share or if you have an opinion, I would love to hear!!


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## Andros (Aug 26, 2009)

CLRRN said:


> Hi Everyone,
> 
> So I've seen the medical experts so now I'm coming to you, the experts with real life experiences.
> 
> ...


Firstly, I would like to say I am so sorry for your partner's troubles and yours. It would seem the sky fell in all at once here. I hope your partner is recovering well? And that the prognosis is good?

Now, you! It does sound suspicious as you well know. Not having had an experience even close to yours limits my comment to one thing.

That being that you may be better off to just have a TT period. Many who keep part of their thyroid usually find stabilizing on thyroxine replacement to be difficult and that is putting it mildly. That has been my observation, not my experience.

We have many here who have been through similar and I am sure they will be along to comment.

Welcome to the board.


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## SnoodMama (Jan 11, 2011)

I'm sorry to hear about this CLRRN. I don't really have anything to offer except a :hugs: and maybe to continue this discussion about a partial thyroidectomy vs TT. Andros, is that really true about the difficulty managing the hormone levels after partial thyroidectomy? I was told by my doctor that the advantage of having only half of the gland removed was that I would still have the half of my remaining (and functional) thryoid to take care of things. She said they'd put me a low dose of synthroid to keep me from going hypo. So I was all happy to hear that this option sounded much better for that reason. But you know others who have had a roller coaster ride after having half the thyroid removed. Ah, man! That pops my bubble! :confused0068:


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## SnoodMama (Jan 11, 2011)

Oops! Just saw this other thread on the very topic of half vs whole thyroid surgery:
http://www.thyroidboards.com/showthread.php?t=3542


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## CLRRN (Jun 22, 2011)

Thanks for the feedback. I mentioned just doing the TT (I'd rather do it and get it over with) but the ENT wanted to be somewhat conservative. I'm going to try and get a consult with an ENDO doc this week. If only the cytology report from the FNA was a little more definitive. Thanks for sending the link!!!!


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## CLRRN (Jun 22, 2011)

Thought I would provide you all with an update. Had the partial thyroidectomy on 8/16 and all went well. They removed the nodule and I did great post-op. No drain, minimal nausea and the pain was controlled with tylenol and ice packs (love them). 
I agreed to the PT because it was a) standard of care for the removal a nodule and b) I had two medical opinions. Although my FNA was somewhat vague/suspicious, all parties felt the nodule was a benign adenoma.
Good thing no one placed a bet on the outcome of the pathology report because it shocked everyone. The path report read :minimally invasive follicular carcinoma with oxyphilic (hurthle cell) metaplasia. The margins were clear and uninvolved, no lymph-vascular invasion, extrathyroidal extension-not present.
I'm scheduled to have the rest of my thyroid removed on the 23rd.
Would definitely appreciate any thoughts/comments on this new information.


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## Andros (Aug 26, 2009)

CLRRN said:


> Thought I would provide you all with an update. Had the partial thyroidectomy on 8/16 and all went well. They removed the nodule and I did great post-op. No drain, minimal nausea and the pain was controlled with tylenol and ice packs (love them).
> I agreed to the PT because it was a) standard of care for the removal a nodule and b) I had two medical opinions. Although my FNA was somewhat vague/suspicious, all parties felt the nodule was a benign adenoma.
> Good thing no one placed a bet on the outcome of the pathology report because it shocked everyone. The path report read :minimally invasive follicular carcinoma with oxyphilic (hurthle cell) metaplasia. The margins were clear and uninvolved, no lymph-vascular invasion, extrathyroidal extension-not present.
> I'm scheduled to have the rest of my thyroid removed on the 23rd.
> Would definitely appreciate any thoughts/comments on this new information.


So glad to hear from you and sadly, I am not at all surprised. Geez; you poor kid. I hate you have to go through this a second time but there is no way you can chance not to.

I wonder if anyone mentioned RAI after surgery? And it will be absolutely essential to keep your TSH suppressed as well.

It appears your surgery of partial thyroidectomy is referred to as a "diagnostic" procedure.
http://www.cumc.columbia.edu/dept/thyroid/follicular.html

It is amazing the similarity to your very own story and experience.

Keeping you in my thoughts and prayers.









Hope you can keep us updated.


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## webster2 (May 19, 2011)

Sorry you have to do it all over again. I had my second one done 7/28, and it has gone pretty well. Mine was papillary, no lymph node involvement. My path. report said hurtle cells too which I thought were an indication of hashimoto's, but I don't really know. Still lots I don't know, or understand. Best wishes for your next surgery.


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## Andros (Aug 26, 2009)

webster2 said:


> Sorry you have to do it all over again. I had my second one done 7/28, and it has gone pretty well. Mine was papillary, no lymph node involvement. My path. report said hurtle cells too which I thought were an indication of hashimoto's, but I don't really know. Still lots I don't know, or understand. Best wishes for your next surgery.


Interestingly, there are Hurthle cells indigenous to Hashimoto's and Hurthle cells indigenous to cancer.

http://cancerhelp.cancerresearchuk....er-different-to-other-types-of-thyroid-cancer

Thyroid nodules containing Hurthle cells are composed
of a wide range of pathologic entities, including
Hurthle cell adenomas, Hurthle cell carcinomas
(HCC), hyperplastic Hurthle cell nodules in
Hashimoto thyroiditis (HT), and adenomatous/multinodular
goiters (MNG) with Hurthle cell metaplasia.
Hurthle cells are characterized by abundant etc..................

http://onlinelibrary.wiley.com/doi/10.1002/cncr.21716/pdf


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## I DClaire (Jul 31, 2011)

Your nodules sound about the same as mine only my 3 cm. nodule is on the right, the smaller ones are on the left. I can honestly say I also have every other symptom you mentioned.

I'm seeing a surgeon this coming week, hoping he'll agree with my endocrinologist and EN&T doctor and remove my whole thyroid - I'm light years past being tired of worrying about all this, specifically wondering/hoping I can get off blood pressure medication post surgery.

I told my husband if surgery doesn't help, I'm going to jump off the nearest bridge!! :winking0001:


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## SnoodMama (Jan 11, 2011)

Well, I'm sorry to hear your path results and sorry that you have to go through it all again, but it will be good to get it all out and have this behind you. I can't believe both you and your partner have had to experience this. I will be thinking of you on the 23rd and following you with surgery (hopefully only one surgery) next month. Any word about followup treatments? At least you know what to expect this time.... Ok that was a dumb comment. Grasping for the 'bright side' here.


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## CLRRN (Jun 22, 2011)

My nodule on ultrasound was 3.2 but was actually smaller once removed (2.4cm). I appreciate all the feedback and comments (and links-very helpful). I'm really trying to be as informed as possible.
There will be no "jumping off the nearest bridge" I DClaire  I live near a big bridge and it's just our thyroid..LOL we can do this. Let us know how your visit goes with the surgeon and i'm voting for the TT!!!!!


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## Octavia (Aug 1, 2011)

CLR RN, your story pretty much mirrors mine, except that my cancer was Papillary, and my tumor was 2.5 cm on ultrasound, but 3.2 in real life. I had pretty much the same symptoms you had (plus my voice felt funny for months), but I ignored them until I saw a lump in my neck, then as things progressed, I started "putting two and two together" so to speak, and it all started making better sense. I was disappointed, but not completely surprised, that my pathology showed cancer, which, like yours, called for the completion thyroidectomy a few weeks later.

My completion was at the end of March this year. My RAI was in May. And today, I'm happy to report that I feel great!

I can't remember whether it was in this thread or a different one, but Andros mentioned that the people who have the entire thyroid removed instead of just half seem to fare better and find it easier to get the right level of meds...I would have to support that conjecture wholeheartedly after reading many of the threads on this forum. Removal of the entire gland seems to eliminate the "roller coaster" experienced by many who had a partial thyroidectomy.


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## MIMAZOLCIAK (Aug 3, 2011)

I don't have much input, I am new here. Sounds like you have got some great input from other posters. Hope all goes well!


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