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Forum Name: Head and Neck Cancer

Question: likelyhood of thyroid nodule being cancerous??


 rosie75 - Sat Jul 21, 2007 3:04 pm

What are the chances of thyroid nodule being cancerous when left lympth nodes are involved?
I have enlarged left lympth nodes (level 1) on my ct scan and nodule detected by ct scan on my thyroid. The ct scan was done because of enlarged lympth node thinking it was a stone on my submandibular gland which turns out to be enlarged lympth node and discovered a nodule on my thyroid. I just turn 32 years old today and scared about it being cancer. I will have ultrasound done on Monday so that my doctor can schedule surgery. He said surgery is highly recommended to remove the lympth node and thyroid so does this mean the liklyhood of cancer is high? My mother had radiation when she was my age for thyroid nodule back in the days. What is the out come for thyroid cancer on a young person?
 Dr. Chan Lowe - Sat Jul 21, 2007 11:21 pm

User avatar Thyroid nodules are actually relatively common. Often they are not cancerous. Unfortunately, I can't give you any specific numbers regarding your "chances" of cancer.

Doing the ultrasound will better help define the nodule. Given that you also have the lymph nodes swollen I would agree that at minimum a biopsy of the nodule/node should be done. Removing it may be the best approach in your case, if your surgeon is recommending it.

My best advice to you is to try not to convince yourself you have cancer and wait for the results to come back. It's easy for me to say but I know it is tough to actually do.

Best wishes.
 rosie75 - Fri Jul 27, 2007 5:37 pm

Update from ultrasound,they found three nodule on my right side. On the ct it only notice only one so this was surprise to me that they found two more. The one is 4mm and the other two is 2mm and all on my right side of my thyroid. My left lympth node is still enlarged and no infection. The enlargement of the left lympth node and hardness is caused by thyroid nodule. I go for thyroid and lympth biopsy on Aug 2 to determine what it is. They think that the rapid heart beats,headaches,and neck swelling has to do with the thyroid nodule. Being that there is more then one nodule and still swelling is it better to take out the right side of thyroid and left lympth node rather then medication? I can not take any oral medications due to gastroparesis it will flare it up to the point that as soon as I take oral medication three hours later I end up in the er and admitted. Any medication I have to take for infection or something else it has to be injection or iv infusion so basically I am a tough case. Is surgery the right route for me? If he would say to wait 6 months or a year to see if any changes can I opt to say no and have him take it out on my request as a precaution?
 rosie75 - Sat Jul 28, 2007 7:53 am

I also forgot to mention to you that I still have hoarsness and swallowing problems due to swelling.
 Dr. Chan Lowe - Sat Jul 28, 2007 4:05 pm

User avatar You may need some further imaging scans such as a nuclear medicine scan to see if these nodules are "hot" or "cold" meaning the nodules are making thyroid hormone or not.

If they are hot they are more likely to need to be removed.

You may want to talk with with an endocrinological surgeon to discuss the benefits/risks of a removal surgery. This will help you make an informed decision.

Best wishes.
 rosie75 - Thu Aug 09, 2007 5:50 pm

I had FNA last week for thyroid nodule. One of my nodule is 1.7cm and the other two are smaller. On my cytology report it says consitent with hyperplasia nodular and also have this on my report
follicular cells:present, in varying sized aggregates and in large sheets
hurthle cells:few
colloid:abundant,thick and thin
macrophages:moderate
lymphocytes:rare
I know right now this is benign but with my family history of thyroid problems/cancer and my symptoms do you think that I am making the right decision to remove my right side of thyroid as a precaution? A friend of mine works in pathology and she mention about follicular cells and hurthle cells that is in my report is concerning. It can be either way benign or cancerous and the way to really find out is when they take it out and do frozen section is this correct?
My doctor want to wait 6 months and then remove it but I rather take it out now. Can anything change within 6 months if I leave it in until then and then take it out? Why does he wants to wait 6 month and then remove it? Is it ok to voice my opinion to him that I want it out or should I take his opinion and wait? My surgery is set just in case for Aug 28 but have pre op consult with him on the 24 to make the correct decision. If we come to agreement then surgery will be Aug 28 other wise it will be 6 months later.
 Dr. Tamer Fouad - Thu Aug 09, 2007 11:58 pm

User avatar Hello Rosie,

I completely agree with Dr. Chan. At this point a good idea would be to get a thyroid scan done. If the nodule is "hot" then this means it's a functioning nodule (makes thyroxine) which means its benign. If it's "cold" then it's not functioning which means it could be cancer and would need to be removed.

Also could you please let us know the results of your thyroid function tests (TSH, T4).

Please discuss this with your doctors and keep us updated.
 rosie75 - Wed Aug 15, 2007 6:02 pm

I went for my medical clearance and check up yesterday and the one has grown more and another one was detected unless that one has grown near my right lymph node,she can also palpate that one too now before couldn't. The 1.7 cm nodule was not palpatal before and now it is, so is the other one unless it a new one. So I want to know can this happen that it can grow within a short time? Its only been a month since they found this. Also this was not there when I had a ct scan last year for my lymph node according my to md. This is a surprise to me and her that it has appeared out of no where. Should I be concern? I have made a decision with the help of my pcp to have surgery to be on the safe side being that it has increase in size in a short time and came out of no where. Now there is a possiblitites that they might do a total thyroidectomy if it comes back positive. What is the recover time after surgery? How risky is surgery?
 Dr. Tamer Fouad - Wed Aug 15, 2007 6:36 pm

User avatar Dear Rosie75,

What are the results of your thyroid function tests and was a thyroid scan done or not? This data is essential to give us an idea of the likelihood that something serious is there.
 rosie75 - Thu Aug 16, 2007 4:28 pm

Thyroid function test came back normal that was done in July and thyroid scan came back warm. He did not give me numbers of the thyroid function test but said it was normal. I also had it done back in June by my pcp and that came back normal also. Can warm be either way benign or cancerous or can it be just benign? Why has it grown since the first diagnoses? Is it supposed to affect your swallowing?

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