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Forum Name: Endocrine Cancers

Question: tumors around thyroid


 Mom28 - Thu Jun 28, 2007 3:13 pm

My mom is a 65 yr old woman of good health. She is currently taking no medications and has a family history of underactive thyroids.

She recently noticed a swelled area on her neck and had a nuclear test and from what she told me, it said her thyroid was working as it should be.

She also had an ultrasound of her neck and found 3 hard masses surrounding her thyroid. She told me the doc said they were large, but I don't now the exact size.

Her doctor is sending her to a specialist to get a biopsy. If it turns out to be cancerous, would that be considered thyroid cancer?

Thank you so much for your time!
 Dr. Tamer Fouad - Tue Jul 03, 2007 9:21 am

User avatar Hello,

A variety of techniques are used to diagnose thyroid cancer. These include: thyroid isotope scans, ultrasonography and fine needle aspiration cytology (FNAC) or biopsy.

Thyroid isotope (nuclear) scans cannot differentiate absolutely a benign from a malignant nodule but can tell us about the probability of malignancy.

“Hot” thyroid nodules, which are able to concentrate radioiodine, represent functioning nodules and are less likely to be malignant. “Cold” nodules are nonfunctioning lesions that do not concentrate the isotope. Most thyroid cancers occur in cold nodules; however, only 10% of cold nodules are cancers.

Ultrasound imaging can detect nodules as small as 2 mm and is useful for determining the number of thyroid nodules and measuring their size.

A nodule in a gland with multiple other nodules of similar size is unlikely to be malignant. However, a dominant nodule in a multinodular gland carries a risk of malignancy similar to that of a true solitary nodule.

Ultrasonography can be used to determine whether a nodule is cystic or solid. Although most solid nodules are benign, thyroid carcinomas usually present as solid nodules. A cystic nodule or a “mixed” (cystic-solid) lesion is less likely to represent a carcinoma and more likely to be a degenerated colloid nodule.

Certain characteristics in a hypoechoic nodule increase the chance for malignancy. These include microcalcifications, central blood flow, or irregular border.

FNAC should be the initial diagnostic test for the evaluation of thyroid nodules. The accuracy of cytologic diagnosis from FNAC is 70%-80%.

From what you have said it appears unlikely that your mom has thyroid cancer. The fact that she has neck tumors around the thyroid could be due to enlarged neck nodes. Depending on the ultrasonographic findings these tumors may or not be due to something serious. It is of course difficult for me to assert but if they were enlarged lymph nodes they can be due to many things, most of which are benign.

A pathological examination, as her doctor ordered, will determine the real significance of these tumors.

Please keep us updated on your mom's condition and don't hesitate to ask more questions regarding her condition.

Best regards,
 Mom28 - Tue Jul 03, 2007 10:04 am

Thank you so much for your reply!

I have the actual results from my moms tests

Thyroid imaging and multiple uptake exam

The thyroid gland is overall asymmetrically enlarged w/ the right lobe being larger than the left. Tracer distribution is significantly irregular throughout both lobes. There is a suggestion of a focal absence of tracer in the mid-lateral portion of the left lobe.

Radioactive iodine uptake values are within the very lower euthyroid range. The image findings suggest the possibility for either multinodular/multicystic degeneration or significant thyroiditis.

Ultrasound

1. A complex mixed cystic and solid nodule is demonstrated in the mid right thyroid lobe. There is a hypoechoic partially cystic complex lobulated and well defined 2.6cm x 1.6cm x 2.6cm diameter nodule in the mid potion of the right thyroid lobe. The right parenchyma is otherwise slightly heterogenous.

2. There is a solid nodule within the anterior aspect of the mid left thyroid lobe. There is a smaller cystic nodule just dorsal or posterior to the solid nodule in the mid left thyroid lobe. There is a solid sharply circumscribed nodule in the anterior aspect of the mid thyroid lobe which measures 10mm x 8mm x 10mm in diameter. Just dorsal to this solid nodule a cystic nodule is demonstrated which measures 4mm in diameter.

If you could help me make sense of this, I would really appreciate it!

Thank you soooo much!
 Dr. Tamer Fouad - Fri Jul 06, 2007 11:48 am

User avatar Hello,

Sorry for the delay. Actually your doctor is right to request a biopsy / FNA from the thyroid. Several characteristics, while not conclusive, warrant further investigation just to be sure. Of particular importance is the complex mixed cystic and solid hypoechoic nodule. This COULD be a thyroid cancer.

Please keep us updated as to the results of the biopsy.

Good luck!
 Mom28 - Fri Jul 06, 2007 2:53 pm

Thank you so very much for your response.

The mass on her neck is visably larger and I am really worried.

I will keep you updated.
 Mom28 - Mon Jul 09, 2007 12:27 pm

A complex mixed cystic and solid nodule is demonstrated in the mid right thyroid lobe. There is a hypoechoic partially cystic complex lobulated and well defined 2. 6cm x 1. 6cm x 2. 6cm diameter nodule in the mid potion of the right thyroid lobe. The right parenchyma is otherwise slightly heterogenous.


Could this be a characteristic of anaplastic thyroid cancer?

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