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Forum Name: Endocrinology Topics

Question: Thyromegaly


 explorer - Fri Aug 24, 2007 11:57 pm

My wife went to the doctor the other day due to some discomfort on the right side of her neck. There is a feeling of some heat sensation and micro palpitations on the right side of her neck. She is 47 years old. We are from the Philippines but currently I am away from my wife and I am working here in China.

She informed me that after the Barium swallow and x-ray or ultrasound the doctor have the following impressions on his result.

Impression:
THYROMEGALY RIGHT LOBE WITH COMPLEX NODULE.

Thyroid lobe is enlarged 50. 7 c 19. 9 x 14. 1
Complex nodule 15. 7 c 13. 3 x 8. 2 is noted on the lower segment.

No focal masses noted.
No calcification.
Isthmus is unremarkable.

The doctor told her to comeback after six months for the same diagnostic routine to measure again the complex nodule if its size is increasing. No medication was prescribe.

We are worried about this situation and we are very much afraid that this might be a cancerous. Can we please get your professional advise and opinion for this and things to do like other further examination request.

Our country does not have a very convincing healthcare system. We are spending on our own pockets most of the time. And is very expensive. Your advise and information will be highly appreciated.

Thank you.
 Dr. Chan Lowe - Sat Aug 25, 2007 3:51 pm

User avatar Hello Explorer,

The vast majority of thyroid nodules are not cancerous. Some may be making thyroid hormone causing hyperthyroidism so even though they are benign (not cancer) they still may need to be removed. Others do not produce hormone (known as a cold nodule, as opposed to a hot, hormone producing nodule).

Having said that, depending on the study you look at, about 10% of larger nodules will turn out to be cancerous. Your wife's node may be considered large or may not (depending, again, on the study used).

Some would advocate doing a fine needle biopsy of the nodule to see if there is any cancerous signs in it.

I would recommend she discuss with her doctor the possibility of having the biopsy done. Again, though, around 90% of these will end up being non-cancerous so the odds are in your favor. 10% is still large enough that many physicians will pursue a more agressive work up.

Unfortunately, the data is still a bit mixed in studies so this aggressive approach may not actually be the best way to go. More research is needed to be more certain.

Best wishes.
 explorer - Sun Aug 26, 2007 7:32 pm

Many thanks Dr. Lowe...

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