# FNA Inconclusive-Surgery or wait and watch?



## donnakd (Apr 8, 2013)

I have had 2 FNABs in the last month, both inconclusive. ENT surgeon says we can schedule surgery to remove half and biopsy, or can wait, watch, and recheck in 6 months. 
I truly don't know what to do. I don't want to have surgery, but would rather have conclusive results.
Any thoughts appreciated.


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## jenny v (May 6, 2012)

Can you remind us about your symptoms? How big are the nodules, are they causing you discomfort, etc.?


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## donnakd (Apr 8, 2013)

My thyroid has been swollen for a few years, PCP had been watching for changes. Thyroid panels always in normal range, but I've had some symptoms of being hypo for years, doc just always said it wasn't enough to treat. When it enlarged within a few months a sono was ordered. Here are those results:
"Findings:
Multiple sonographic images of the thyroid. Right lobe 4.8x1.5x1.9cm. Left lobe 5.0x1.7x1.2cm. There is a dominant solid mass within the mid to lower right lobe measuring 3.4x0.9x2.2cm. There is a complex cystic mass with irregular margins and irregular central solid echogenicity measuring 2.1x1.4x1.8located in the lower pole of the left lobe. Thyroid isthmus is normal in thickness measuring 4mm. No other discrete sold or cystic mass. 
Impression:
1. Dominant solid mass in the right thyroid lobe measuring up to 3.4 cm 2.1 cm complex solid and cystic(although predominantly cystic) lesion in the lower pole of left lobe. Neoplasm cannot be excluded. Further evaluation with thyroid scintigraphy and/or tissue sampling may be considered as clinically indicated. "

First FNAB was very uncomfortable to me. The area is very vascular, and it bled a lot. Results inconclusive due to too much blood in sample. Had it redone this past Tuesday. Results inconclusive but did say no papillary neoplasm in sample, but recommend either remove half for biopsy now, or repeat sono and FNA in 6 months. I haven't read the report myself, will go by and get it. 
Thanks!


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## KeepOnGoing (Jan 2, 2013)

I had 3 FNAs, none of them at all conclusive. When they removed the nodule, it was malignant. I, too, was looking for a definitive answer - and I got one! Just not the one I either wanted or expected.

But then again, I'm sure lots of people will be along soon saying that theirs was perfectly innocent. Depends how you cope with uncertainty - I'm one of those people who needs to know...


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## joplin1975 (Jul 21, 2011)

I, personally, would be leaning toward surgery, but given that I'm a weenie and hate surgery, but would opt for a total rather than a partial since you have nodules on both sides.


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## donnakd (Apr 8, 2013)

I want to know something definitive. Thanks and keep those replies coming!


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## Andros (Aug 26, 2009)

donnakd said:


> My thyroid has been swollen for a few years, PCP had been watching for changes. Thyroid panels always in normal range, but I've had some symptoms of being hypo for years, doc just always said it wasn't enough to treat. When it enlarged within a few months a sono was ordered. Here are those results:
> "Findings:
> Multiple sonographic images of the thyroid. Right lobe 4.8x1.5x1.9cm. Left lobe 5.0x1.7x1.2cm. There is a dominant solid mass within the mid to lower right lobe measuring 3.4x0.9x2.2cm. There is a complex cystic mass with irregular margins and irregular central solid echogenicity measuring 2.1x1.4x1.8located in the lower pole of the left lobe. Thyroid isthmus is normal in thickness measuring 4mm. No other discrete sold or cystic mass.
> Impression:
> ...


Have you seen an ENT? Are you comfortable w/not having your thyroid out? There are quite a few things that are worrisome.


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## jenny v (May 6, 2012)

Based on the issues you've had with both FNAs, I don't think you're going to know anything definitive until they go in and remove half or all of it and send it to pathology.


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## donnakd (Apr 8, 2013)

I just picked up the lab report. It reads:
"Final diagnosis:
Fine needle aspiration, right thyroid module:
-Limited colloid material and few small bland follicular epithelial groups, non-diagnostic.
-no cytologic evidence of a follicular neoplasm."


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## donnakd (Apr 8, 2013)

Yes, An ENT performed FNAs.


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## donnakd (Apr 8, 2013)

Andros said:


> Have you seen an ENT? Are you comfortable w/not having your thyroid out? There are quite a few things that are worrisome.


Andros, would you mind telling me what you see as worrisome? Is it that there is more than one, on both sides, vascularity, etc?


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## donnakd (Apr 8, 2013)

I still don't know what to do. I made an appointment with the ENT(who did both biopsies and would do surgery), but his earliest appointment is May 7. Also got on cancellation list to try to get in sooner. I'm leaning toward not waiting, but will see what he says. 
Would still love input if anyone has any! 
Thanks so much!!


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## donnakd (Apr 8, 2013)

My SIL's mom is a nurse who retired last year. She was a nurse for a local surgeon for 15 years. She told me the other day to bring my us and lab reports by and she'd show them to him and get his opinion. He says I shouldn't wait. So I guess surgery is in my future. I'm thinking I will wait until after my daughter finishes this semester. I'll keep y'all posted!


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## joplin1975 (Jul 21, 2011)

Honestly, I know surgery is no fun...but I swear it's not bad and, for me & my worry wort frame of mind, having closure and definite answers would out weight the negatives, ya know?


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## donnakd (Apr 8, 2013)

Yes, Joplin, I do know! Worry wort here, too!! The thing I want the most is DEFINITE answers!


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## Nowensmama (Mar 28, 2013)

Having a long time to worry about it was the worst for me. I kept postponing it because of a trip, then my kids birthdays. I had so many months between my consult and my surgery that my anxiety got seriously out of control. I think if I'd scheduled right away it would have been so much better.


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## Andros (Aug 26, 2009)

donnakd said:


> Andros, would you mind telling me what you see as worrisome? Is it that there is more than one, on both sides, vascularity, etc?


Solid mass is the most concern but the entire thyroid is unhealthy. Vascular also suggests cancer as it "usually" has it's own blood supply and the fact that they stated they cannot rule out a neoplasm.


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## donnakd (Apr 8, 2013)

I called and talked to my ENT's nurse and made a surgery consult appointment today. Will see him the 25th. She said they are scheduling surgery 2 to 3 weeks out, and would be on a Monday so we're looking at possibly the 13th.


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## donnakd (Apr 8, 2013)

I think I've decided(with hubby's help) to go ahead with surgery. It is such a hard decision to make! The ENT(also h & n surgeon) said 85% chance of being benign. And he'll have a pathologist there to biopsy, hoping to find something out then. We will schedule after insurance approves it. Looking at 2 to 4 weeks from now. I hope I'm making the right decision. UGH, again, so hard!!


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## webster2 (May 19, 2011)

Best wishes, I have never regretted losing my thyroid.


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## joplin1975 (Jul 21, 2011)

I, too, have never regretted going without a thyroid. I hope things move along quickly for you!


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## donnakd (Apr 8, 2013)

Surgery is set for June 3rd. I wish it were sooner, but at least it's not something that has to be done ASAP!


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