Suggest Remedy For Nodule On The Thyroid Gland

Posted on Wed, 25 Feb 2015

Question: I have a 1.1cm X .7 cm X .5cm dominate nodule on my thyroid. My mother had medull. cancer of thyroid at 80 and I am 60 and male. Having a FNA Tuesday. My main question is if this is cancer would it be considered an early detection at this stage and size ?Discovered by having my yearly physical and ask to have a sonogram of my thyroid .

Answered by Dr. Binu Parameswaran Pillai (6 hours later)

Brief Answer:
FNA can detect malignancy.

Detailed Answer:
Good day,
Noted your concern. yes, an FNA can detect malignancy from a 1.1 cm lesion. However, multiple slide preperaton will be required .
Besides, i would advice you to do a fasting "serum calcitonin" which is again a marker of medullary thyroid cancer(MTC) . Make sure that you are not taking any anti acid pills 2 weeks prior to doing the "calcitonin" test.

However, i must say that, other types of malignancies ( follicular, papillay) are more common than Medullary thyroid cancer. And over all, there is only around 1-5% chance of any type of cancer in a nodule which wa incidentally detected. Most often, they are benign nodules

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (28 minutes later)

If it is cancer would you think at this size it is more likely to have not spread ? And is the next step to remove the thyroid and lymph nodes in the neck? I am concerned about it and lymphnomia .

Answered by Dr. Binu Parameswaran Pillai (5 minutes later)

Brief Answer:
RET mutation study

Detailed Answer:
Please do not worry. As i previously mentioned, most thyroid nodules are benign. And even if it turns out to be malignant, at this size of 1.1 cm, that is very unlikely to have spread outside the capsule. However, a final answer can only be provided after the surgery. If the FNA shows malignancy, then yes, surgery is recommended. Again, choice of thyroidectomy with lymphnode dissection is based on the FNA report and clinical examination/ultrasound findings.

If your mother had MTC, did she have a RET mutation study done?? If that was positive, yourself as well as your siblings also should consider getting a RET mutation study done. If this is positive, you will benefit from a prophylactic thyroid removal irrespective of the FNA report.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (18 minutes later)

As i remember she was tested for something to see if it was a type that was passed down but was told that it wasn't and we didn't need to be tested. But just found out from my brother that a letter stated that we should be checked yearly . This was from 1998.

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Free from genetic form of medullary thyroid Ca

Detailed Answer:
Okay. If her RET mutation was negative, you are free from genetic inheritance of Medullary cancer. The letter probably mentioned that you should have an annual thyroid examination and a calcitonin level check ( based on examination finding).

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar