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Old 12-24-2012, 07:10 PM   #1
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4.4cm Thyroid Nodule, Making Sense of Everything...

I started feeling pretty crappy this past July. I began to see a therapist as I began to wonder if I was suffering from depression (moody, non stop sleep patterns, strange acne break outs, loneliness, etc). I work a high stress job and mother was diagnosed w/ cancer this summer as well so I was also contributing my "blues" to stress.

Back of my neck started hurting me but I was contributing this to exercise (which I used to do frequently but fell out of the routine and started to gain some weight, decided to crank it back up because I was feeling rough). During a routine neck rubbing, I noticed something protruding from the front of my neck. I looked in the mirror, looked like an Adam's apple which appeared to be offset by a couple of inches.

Called the doc, she immediately said, "Yep! Time for an ultrasound and bloodwork, that's your thyroid." Funny, I showed it to my boyfriend, he said he had seen it for months (why I did not, who knows, I am a busy gal).

Had an ultrasound, they found mass of course... I quote:

"The right thyroid lobe is largely occupied by a very large mostly cystic mass, over 4cm in diameter. A mural nodule within this mostly cystic lesion measures 15x25mm. The nodule itself is partially cystic. There is no hypervascular tissue associated w/ this lesion. Along the margins of a loculation of the cystic portion of the mass inferiorly there are high-level echoes that have the appearance of a colloid. The palpable mass is probably degenerated or hemorrhagic colloid nodule. Follow up sonography recommended in 6 months."

There is also a 1.7cm nodule in the left lobe w/ no thickening of the isthmus.

I asked to be refered to an endo, she looked at my bloodwork, said it was fine. However, she said, "It is very large and I know you've had a rough year so I don't want to say the "C" word but you must have a biopsy."

Here's my bloodwork:

TSH-.981
T4-6.9
T3 Uptake-32
Free Thyroxine Ind-2.2

Ironically, last year I had run 2 half marathons and had some pretty severe headaches that put me into MRI territory, my dr had some bloodwork done too just for fun. I had a CSF leak, which healed, no big deal. I grabbed my scans/reports (kind of a nerd like that!) and there was an incidental finding of that silly right lobe nodule which none of us (dr included) caught. It was 2cm about 1 year ago.

My bloodwork then was:

TSH-.06
T4-5.7
T3 Uptake-36
Free Thyroxine Ind-2.1

OK, so the reality is this.... I am having a FNAB very soon but the internet has a tendency to overload folks w/ so much information that even an educated person can get confused.

Give it to me straight, if I'm looking at cancer, at least it is easy stuff by comparison.

Thanks and Merry Christmas!

 
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Old 12-25-2012, 05:59 AM   #2
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Talking Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

If you have such a large growth of 4cm, that's not a nodule, and it might just be that you have a multinodular goiter---a lumpy bumpy thyroid (usually benign). The problem is, it's so large, you aren't going to get rid of this with anything but surgery. A fna isn't going to give you enough information, you are going to need a pathology with such a large growth. This is large, and is growing out of control, and can grow into your chest and wrap around the structures of your neck.

It's also growing fast based upon what you said. You need to see an ENT a good thyroid surgeon---look for a specialist at a cancer hospital if you can find one, or at a major teaching hospital. I don't think you have cancer, but I think you have to look at getting that out of your body.

Ironically, I found my cancerous thyroid nodule after crying and crying when my mom discovered her advanced breast cancer, 8 years ago. The good news is I'm fine, no worse for the wear---and by some miracle, my mom is still around.

Everything will be fine, but you need to find a great surgeon first.

 
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Old 12-25-2012, 08:05 AM   #3
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

"A fna isn't going to give you enough information, you are going to need a pathology with such a large growth."

Can you clarify what you mean above so that I can ask? Not sure what other options are out there to test the cell's behavior unless we open the neck and take a sample after the thyroid is removed (maybe that's what you mean anyway).

It's funny, I've not had a ton of trouble w/ exercising, ran a 5k about a month ago. However, I always feel like I have a pill stuck in my throat when I swallow and I guess I snore horribly (I do wake myself up w/ these random hacking noises... which I laugh because it irritates my boyfriend). In all seriousness, I'm sure thyroid removal will be the ultimate path that I take, just trying to prepare myself since I have this tendency to be oblivious to my body's changes.

My FNAB is tomorrow, I will post when I hear the results. Thanks for the reply and have a good holiday!

 
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Old 12-25-2012, 08:20 AM   #4
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

Exactly--most types of thyroid cancer are found when you remove the lobe and see if the cells are encapsulated in the nodule--also, for other types, a needle biopsy only takes a very tiny sample of cells on the needle biopsy---if you have a large nodule/tumor mass, it isn't going to tell you what the rest of the cells are like, just the ones that you have drawn out.

Your mass or goiter is quite large, and then you have very large nodules in addition, it is likely giving you constriction symptoms.

Good luck with your needle biopsy.

 
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Old 12-29-2012, 07:20 AM   #5
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

So, I had the FNAB, not a terrible experience but not what I expected either. I was given a local injection (4 different occurrences) and they took 4 biopsy samples. There were 2 solid nodules inside the cystic portion. Only the suspicious one was sampled.

The ultraound tech called the sampled nodule "sparkly" which caught my attention. I've read enough to understand that terminology with regard to calcification. She also showed me the image and said the nodule was not consistent, its margins were not defined well at all. It was very obvious to me, it looked like and an amoeba.

Oveall, I deduced that the staff had not seen a thyroid this big nor had they performed a biopsy on one of this size. Normally they are caught before they reach this size (my neck is around 13" normally, it is 15.5" now), but, hey I was busy! No excuse....

At this point, the goiter is becoming obstructive. I can only sleep in one position due to snoring and comfort and I'm starting to have signs of tinnitus in the right ear. I am confident that is tied to the invasive nature of this goiter on the surrounding tissue and blood vessels.

So either way, if my results come back positive/negative for carcinoma, the thyroid and its new found family, has to be removed.

 
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Old 01-20-2013, 06:37 PM   #6
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

As an update, my FNA for the RH nodule came back as a benign colloid nodule. So good news for sure! However, my complete thryoidectomy is scheduled for this Wednesday as the ony other option was continual drainage (no thanks!).

I've decided to go to the Cleveland Clinic and feel very confident in my surgeon's abilities...

I will update everyone after removal of this monster!

 
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Old 01-26-2013, 06:27 AM   #7
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

Hello! Total thyroidectomy complete and I already feel way better! My awesome surgeon took a photo of what they removed and she said she was shocked that I could breathe let alone exercise. When she made the incision, she said the trachea normally pops right up in the center but instead it was displaced to the left side of my neck. No wonder I could only sleep in one position...

I have to say, the surgical experience was awesome (well as awesome as surgery can get) simply due to the amazing staff and the fantastic surgeon. I picked a doctor who only does endocrine surgeries on a daily basis (and I traveled to get to her).

My recovery has been excellent and I am glad I made the decision. I already have energy and want to start working around the house but don't because I need to heal (this is probably a direct result that I sleep through the night now!). It will be interesting to see how my body accepts the synthetic hormone but just like anything in life, you gotta give it a little time to see what happens.

 
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Old 04-11-2013, 12:09 PM   #8
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

I am new to the board..

I recently had an ultrasound done that found multinodule goiters, here are my results..

The right lobe of thyroid gland is diffusely heterogeneous in
echotexture and lobular in contour. It measures approximately 5.3 x
2.1 x 2.2 cm in craniocaudad, AP and transverse dimensions,
respectively. There are multiple nodules throughout the lobe. The
largest nodule is complex cystic in echotexture and measures 2.1 x 2.0
x 1.7 cm. This is located in the inferior pole. On color Doppler
imaging, flow is seen at the periphery. No sonographic evidence of
calcifications.

The left lobe of thyroid gland is diffusely heterogeneous in
echotexture and lobular in contour. The approximate measurements are
6.1 x 2.1 x 3.5 cm in craniocaudad, AP and transverse dimensions,
respectively. Multiple nodules are identified throughout the lobe. The
largest one in the mid portion measures 4.0 x 3.5 x 2.4 cm. This is
heterogeneous in echotexture. Slight vascular flow is seen within it
on color Doppler imaging. No sonographic evidence of calcifications.

Isthmus measures 5.4 mm in thickness and is within normal limits.

i am terrified its Thyroid Cancer, and having to have surgery.. I just wonder what others think so the results..

thanks

 
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Old 04-12-2013, 12:52 AM   #9
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Re: 4.4cm Thyroid Nodule, Making Sense of Everything...

I think your thyroid is kinda lumpy from the sounds of it. (heterogeneous). You have a number of nodules, one on each side are kinda medium to big. Usually they'll biopsy (FNA) any nodule over 1cm. Which is usually not a big deal. When they did mine, it didn't hurt, but my neck was sore the next day.

I think from what I've read if you have nodules it's a 90-95% chance that none of them are cancerous. The size doesn't matter, and the number of them doesn't matter. And also most types of thyroid cancer have a cure rate of nearly 100%.

So should not be terrified. The only issue is your nodules are a bit big.

I don't know what other symptoms you have. That might also effect whether they'll recommend surgery. If it's causing you discomfort or other problems, or of a biopsy comes back indeterminate or positive for cancer, they may want it out. if they aren't causing you trouble and the FNA is benign then they may just watch them.

I think thyroid surgery is usually not a really big deal if done by a surgeon that is well practiced and experienced. If they pull out your whole thyroid then you have to stay over night. If only half, then I think it's often an out patient procedure. (Lot of people that post here have had theirs out)

Good luck.

 
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