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Old 05-21-2012, 06:51 PM   #1
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Prominent hypervascular mass

Has anyone been dx'd with a prominent hypervascular mass on their thyroid? If so, were they able to get enough tissue samples for biopsy?

With me, the dr attempted to biopsy but I developed a large hematoma immediately and so the dr was only able to get one sample. It was done in his office. Dr was concerned because he didn't think the cutting was enough of a sample. Apparently it was though, and results came back that the mass was engorged with blood and my lymph nodes were enlarged. Lately though, I have been having an uncomfortable feeling when I swallow (at times) so my dr ordered another ultrasound which shows the mass has enlarged since the last ultrasound 3 months earlier when this all began.

I have had Hashimoto's for 10 years now with multi-nodular goiter. I'm currently taking Levoxyl 200mcg and 5 mcg cytomel.

Has anyone had a hypervascular mass on thyroid before? This time when they do the biopsy will be under anesthesia and in hospital outpatient procedure due to hypervascularity. I am still concerned though because I will most likely develop another hematoma as previously and they won't be able to obtain enough tissue samples again.

I'm also concerned because it has enlarged over a short timespan.

Thank you.

 
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Old 05-22-2012, 04:43 AM   #2
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Re: Prominent hypervascular mass

What kind of doctor are you working with? What country are you in? What size is the nodule?

I would skip the fna if it was becoming so difficult to do a biopsy, and if it were in the 2 cm and up range, I would consider a lobectomy. The fna just doesn't give enough information to warrant all this effort. Many are "suspicious" or "inconclusive" so I wouldn't go thru. anesthesia to biopsy it, if I were going through all that I would just remove it already.

 
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Old 05-22-2012, 10:01 AM   #3
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Re: Prominent hypervascular mass

The first us I think said the mass was 3.4 in size (my dr said it was large and had apparently been there long time) but i do not have the report with me but going to get a copy of it along with the recent us this past week. The dr's ofc called me though and said the results were in and it had increased in size from first us approx 3-4 months ago. He said I may want to consider that they will remove thyroid when doing fna.

Do you happen to know if hypervascular means more likely to be malignacy or not? I found some articles that this is the case and then others state just the opposite.

I need to locate surgeon with appropriate experience to do the biopsy an then surgery if necessary. This will be the hard part though. I really think they just need to remove entire gland as my dr said my entire gland is very enlarged. I'm not sure my insurance will cover removal though without a biopsy result indicating the need to do so.

Thank you for your response.

 
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Old 05-22-2012, 10:04 AM   #4
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Re: Prominent hypervascular mass

Oh, I'm located in United States. My dr is an endo.

 
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Old 05-22-2012, 10:58 AM   #5
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Re: Prominent hypervascular mass

So basically you have a thyroid lobe, growing on your thyroid lobe----like a tumor the size of your thumb, growing on your thumb if you want to visualize this.

Your insurance will certainly cover removal of such a large mass, no doubt. If the surgeon wants a biopsy s/he will worry about it, but this warrants removal even if benign because it is growing, and very large.

It really has to go. Again, no value in that biopsy. I would go to a teaching hospital and meet the ontorongology department and find someone really good with thyroids and get this out. If not look for a really great ordinary ENT that you like that does tons of thyroids. Is this endo. a surgeon too? Most endo's aren't. An fna is a closed needle biopsy--non invasive. If you were being cut open, that is major surgery, and you want an excellent surgeon to avoid any damage---why would you take the risk for this when there's already been an issue? They will do a full pathology from the surgery, which is the only way to really determine cancer---they will probably do a frozen section pathology during the surgery as well to see how much to remove.

In most tumors, hypervascular is a red flag for cancer (my cancerous thyroid nodule was vascular) but my thyroid surgeon explained that this is a very vascular area, so it's less meaningful. With that growth, this has to go sooner rather than later. Tell your endo. to cancel, and that the surgeon should help you decide your next step.

Last edited by Reece; 05-22-2012 at 11:37 AM.

 
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Old 05-22-2012, 04:01 PM   #6
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Re: Prominent hypervascular mass

Reece... Thank you. Everything you have written makes absolute sense. I put a call into my dr's office to discuss my options. I plan on telling him that I want to go ahead and have my entire thyroid removed. In addition to the 'prominent mass' my complete thyroid gland is enlarged including the area in the front and I don't especially want to be in a position where I'm always wondering if it is elsewhere in my thyroid...did they get it all, etc... Believe me, I do enough worrying as it is--I have multipe autoimmune diseases already and I don't want to add cancer to the list. Besides, I already have hypo (Hashimoto's) and have been on thyroid meds for a good ten years now, so I'm thinking what will change? Probably nothing...right?

I just wish I already had my us results. The dr's asst. refused to read results to me saying he knows I've been through a lot lately and he didn't have results in front of him anyway and I needed to come in and talk to the dr.

I do have a question about what exactly to expect following the surgery? I have cervical spondylosis and 2 herniated disks in my neck and while I'm currently taking pain meds for this, the pain never completely goes away, and at times, it gets pretty intense. I'm mentioning this because when the surgery is completed, it will probably be a bit painful...you think?

Also, will I need someone with me when I come home from the surgery?

 
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Old 05-22-2012, 05:18 PM   #7
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Re: Prominent hypervascular mass

Nowdays, they usually keep you overnight after thyroidectomy, because they want to monitor calcium. Basically it's an outpatient procedure, and like so many of these, it's good to have someone around the first few days. Everyone heals differently, this is not usually too difficult a surgery, but you want to be safe.

I think you have to discuss the neck issues with detail with a surgeon, because I would be concerned about the situation during the surgery. There have been people here on this board with neck issues, but it was long ago, and the posts may be hard to find.

Keep us posted on what happens, hopefully it will be easy and speedy recovery, the main thing is to find a great surgeon.

 
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