# New (?) nodules after thyroidectomy



## Rosario (Nov 3, 2013)

I had a partial thyroidectomy at the end of last year. Surgeon and internist said levels were fine so no meds. I had symptoms. I went to see an endocrinologist. He wanted to do an ultrasound (not sure why) and he noted nodules on the side where I had the gland removed. They are big 2.0cm and 1.5cm. It's his opinion these did not suddenly grow in 4 months. Surgeon never disclosed that she left any nodules because of any reason. I made her aware of the nodules and she said it could be surgery material which gets absorbed over time. No mention of nodules which couldn't be removed. I asked the endo if there was a scenario where these could be new. He said only fast growing cancer which is extremely rare. I had biopsies done. Inconclusive but not high likelihood that they are cancer. I only had a partial because the nodules/thyroid on the left side were pushing on my throat. All tests for that side came back benign so there was no other reason. The two new(?) nodules are next to my throat and I feel the pressure. Why did I have surgery? Is this malpractice? I am thinking yes. This matters because I am facing another surgery, more Afirma fees and more surgery bills. Any advice? Input? Thank you!


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## joplin1975 (Jul 21, 2011)

Oh, ouch, I'm sorry you're having such a rough experience.

Do you happen to have the pathology report from the first surgery? If so, could you let us know what it says?


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## Rosario (Nov 3, 2013)

The pathology said all benign. oddly it only mentioned 2 nodules and some other tissue in cassettes. the original ultrasound mentioned 4 nodules. that would explain my 2 "new" ones. I am hoping that is it and not that I have some unknown condition which caused these nodules to grow to this size in 4 months. I keep researching and cannot find any case like mine. My current endo is being very cautious on what he says about the origin of these nodules since I am clearly upset. I am back to square one but now I am at out money, have a scar, etc.

Another odd development is that one of these nodules was biopsied recently and came back with hashimoto cells. Every test I have had came back normal and no antibodies. I guess this nodule wasn't biopsied before and that a nodule can have these cells but not the gland. Learning every day. Still no recommendation for meds.


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## joplin1975 (Jul 21, 2011)

Uh. That is strange.

My thoughts (which likely won't be helpful, but...): it would be really, um, odd for your first surgeon to "leave in" two nodules. That is, nodules aren't discrete structures. They are attached to/part of the thyroid. It's why no one has a nodule-ectomy. You have to have a partial, hemi-, or total thyroidectomy. I certainly can't explain the discrepancy between the u/s report and the pathology report, but even if he did, for some odd reason, cut out two nodules and leave them in your neck, I don't see how the tissue would survive without being "attached" to you thyroid.

Thyroid tissue can and does grow back. It seems more reasonable to me that these are new growths of some sort. Which is a long way of saying I don't the think malpractice (if it did occur) took place during the surgery, but rather in your follow up care. Malpractice usually = a violation of standard of care and the standard of care in this is case means regular blood work after your PT to see if higher other side is kicking out enough hormone. If your TSH was high enough, it is a stimulating hormone, which could cause rapid regrowth of tissue (benign or not).

Do you have copies of your latest blood work?


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## Rosario (Nov 3, 2013)

Thanks Joplin. All tests have been normal. My TSH at follow up (a month later) was around 2 and it is 3 now. All other levels (Free 3 and Free 4) have also been within range. The endo can't imagine how nodules that look this way in biopsy could have grown this fast with my levels. I think everyone is stumped. If my body created this, I am at peace and will just schedule my full thyroidectomy. If my doctor rushed (there was an approaching snow storm which shut the city down) and somehow missed nodules that were separate from the thyroid then I want to know. I know that doesn't sound likely but on the other side I have a huge nodule that is barely attached to the thyroid. I left it in. I was thinking I could live with it and avoid meds.


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## joplin1975 (Jul 21, 2011)

Well, for most folks with thyroid disease, a TSH of 2-3 is much too high...and as you know, it's less important that your frees are in range and more important that your frees are at optimal levels. So, in that respect, your original doc didn't do you any favors. But, yes, the rest is a bit of a mystery. It does sound like you've got a good doc now...keep us updated!


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