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    Old 03-28-2009, 06:24 PM   #1
    JanKR
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    New to the Nodule scene....

    Hi,
    I am trying to find some information on the growth rate of thyroid nodules and when one should be concerned. I had an incidental finding of a single 7mm nodule on the right lobe of the thyroid on a carotid ultrasound in November 2007. I had gone to my primary MD then due to right neck, behind the right ear and right facial pain. Six months later the US showed a couple of nodules with the largest being 8 mm. One year later (March, 2009) I have "several" 9mm nodules. My primary MD states that protocol is to wait until the nodule is 1 cm. to do the FNA. However, I have read that papillary cancer nodules are sometimes smaller than 1 cm.

    My TSH, T3 and T4 levels have all been normal each time they were checked. These are the only thyroid studies I have had done. For the last six months or so I keep feeling fullness in my throat and keep feeling like I need to clear my throat but never have anything there! Kind of a dull ache, sore throat feeling also. I was OK with the wait and see mentality until I started having this problem with my throat. Just curious what others experiences were with asking for an endo referral and being pushy about further work up. I will appreciate any input as I can't really find out what is considered a fast growth rate for a nodule on any of my internet searches.
    Thanks in advance for any info or advice.
    JanKR

     
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    Old 03-28-2009, 06:47 PM   #2
    Reece
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    Re: New to the Nodule scene....

    Are you seeing an ENT or an ordinary primary doc who ordered the tests? With all the neck issues you seem to be having it seems that if you need referrals, you can certainly justify seeing an ENT, and the ENT can evaluate the nodules further. 9mm is close enough to 1cm to warrant a biopsy, as long as they are located that they can be reached easily via needle.

    Some endos do needle biopsies in their offices or order them from radiologists, and most ENT's can do it themselves, so you are justified in seeing a specialist, especially since you are having neck pains and ear pains which may or may not be from the nodule.

    It could be that you are sprouting those nodules from thyroid disease, but the quick growth is a red flag for further testing such as an FNA.

     
    Old 03-28-2009, 10:53 PM   #3
    JanKR
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    Re: New to the Nodule scene....

    Thanks, Reece. I am seeing my primary currently and he has been ordering the US but it is an HMO and he does everything by protocol. I will be in his office on Monday and think I'll insist on a referral. I'm also seeing a radiologist on Tuesday as they called on Friday and said they need to repeat my mammogram due to a question on the left so that has me worried also. I will take the US reports with me to the radiologist and see what his opinion is on the nodules. I appreciate your response very much.
    JanKR

     
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