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Old 10-27-2011, 12:22 PM   #1
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Follicular Neoplasm - have a TT?

I am new here, but had some questions. My FNA showed "colloid, histiocytes and thyroid follicular cells in microfollicular groups suspicious for follicular neoplasm."

The lump was discovered by an Endo who I was referred to by my PCP after we could not find a reason for me being so tired, weight gain etc. My tests were all normal and we were going to discuss some options when he found the lump. I went straight for a US and my measurements were:

RT: 5.6 x 1.7 x 2.5cm with Predominantly solid nodule measuring 3.1 x 1.5 x 2.5cm.

LT: 5.7 x 1.2 x 1.4 with tiny scattered nodules measuring less than 3mm.

Then the FNA. My endo is recommending a TT because there is no way to know how long the nodule has been growing and due to presence of other nodules in other side. I am concerned about having it totally removed and finding out it was benign - then there is the whole cost thing on it is cheaper to have one surgery vs two......

No history of thyroid cancer in family - but there is liver, breast, and throat in both maternal and paternal grandparents.

Does anyone have any thoughts about this? I am being referred to a surgeon that my PCP uses for most breast and thyroid surgeries. Any questions I need to ask?

Thanks.

 
Old 10-31-2011, 09:33 AM   #2
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Re: Follicular Neoplasm - have a TT?

I too am having angst over what to do.

What did your FNA show? If it is just because of size.....the wait and see treatment should be fine. Wait three months and ultrasound again. Again, I don't know what your FNA showed. If there are suspicious cells, then maybe a TT would be the best option. But I agree, it would be a shame to have a perfectly healthy thyroid taken out.

I am sorry I don't have any more answers for you. Perhaps if you posted your FNA results with cell description that might get people talking? I don't know. Sorry

Best of luck.

Last edited by moderator2; 10-31-2011 at 09:50 AM. Reason: posted disallowed website

 
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Old 10-31-2011, 09:38 AM   #3
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Re: Follicular Neoplasm - have a TT? FNA Results attached

RTL: Measures 5.6 x 1.7 x 2.5 cm.

There is a heterogeneous, predominantly solid nodule in the inferior polo of the RL measuring 3.1 x 1.5 x 2.5 cm. There is an add'l -5 mm nodule in the right lobe proximal to this lesion.

LTL: measures 5.7 x 1.2 x 1.4 cm. There are tiny scattered nodules in the left lobe measuring -3mm or less.

Isthmus measures 2.6-mm in AP diameter

FNA:

Colloid, histicytes and thyroid follicular cells in microfollicular groups suspicious for follicular neoplasm.

 
Old 10-31-2011, 09:43 AM   #4
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Re: Follicular Neoplasm - have a TT? FNA Results attached

Yes. It does indicate that something could be going on. It is indicating that there are cells that cannot be determined unless the thyroid is removed. If I were you, and the doctors are pushing for surgical removal, I would have the TT. If you are not comfortable with that approach, seek another opinion.

Sorry I could not be of more help.

 
Old 10-31-2011, 09:47 AM   #5
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Re: Follicular Neoplasm - have a TT?

Your thyroid is quite enlarged---it's a "goiter" with a very large nodule on it (3-4 cm is the size of a normal thyroid lobe). Your thyroid is overgrown, and there will likely be more nodules to worry about on the other side in the future---it can also grow out of control itself, and constrict your airway and other structures in your neck, even if it's not cancer. The nodules there will probably grow as well on that side. I agree with the surgeon, this is a pretty diseased thyroid, and should go.

BTW, the regular thyroid board is very active, you may try there for support.

Last edited by Reece; 10-31-2011 at 09:47 AM.

 
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Old 10-31-2011, 06:44 PM   #6
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Re: Follicular Neoplasm - have a TT?

My u/s showed 1.4cm nodule on left and 4mm on right. FNA suspicious for papillary but also features of medullary. My endo and surgeon recommended TT and neck dissection to get rid of right side nodule same time. I was happy with this suggestion in case turned out to be medullary. I really wanted all done in one surgery if possible. One thing that helped me was finding a surgeon whose bread and butter is thyroidectomies. I was confident in his hands the risks of complications in going for full thyroidectomy was low. In the end my tumor was smaller only 1.1cm. There was no mention of the other nodule so I think maybe that was u/s error. Not sure. Some might think I had too much surgery for small tumor but they removed 7 lymph nodes and all clear of cancer. That puts my mind at ease. I may not even need RAI.
Personally I would go for TT if I were you, especially if advised by your endo. But I would try and get some info on your surgeon.

 
Old 11-02-2011, 05:20 PM   #7
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Re: Follicular Neoplasm - have a TT?

My situation was similar...my biopsy only showed a follicular neoplasm, in the left lobe and a smaller nodule in the right that they didn't biopsy. The surgeon recommended left lobe removal, thinking it would be benign. I had a bad feeling and requested a complete thyroidectomy, but he didn't want to do that since you can function without meds with half a thyroid. I had the half done and the pathology came back as cancer, so I ended up having a second surgery 8 weeks later. Fortunately, pathology on the right half came back fine, so for now, I don't need RAI. I consulted three specialists and only one would do RAI now, the others said it's fine to "wait & see"....they will check my blood every 3 months and if something is off, they can opt to do it then.

If costs are a factor, having the TT now would be smart; I have to pay 20% of my medical costs, and the first surgery was over $22,000 and the second was $44,000! In all honesty, I'd probably opt for a total now, rather than risking the chance of a second surgery. Maybe get a second opinion and see what they say. Good luck with whatever you decide!

 
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