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What Are The Findings From The Biopsy Report?

Posted on Sat, 15 Feb 2014

Question: Respected Sir, My wife (Female,35 years old,Height-5`9",Weight 104 kg) has Right hemithyroidectomy on 06.01.2013. She has no previous history of Blood Sugar or High Blood Pressure. On 14.10.2013,she delivered a healthy Baby Girl after a cesearian operation. She used to take Eltroxin (Thyroxin Sodium IP 25 mcg) 25mcg since 01.01.2013 because of a simple goitre in her right neck. She take this medicine during her full pregnancy period, as per medical advice. Presently, she also take Vitamin D3 60000 (D-Rise 60 K) units capsule once in a week (advised to take for 8 weeks,because of her low vitamin D level i.e. 7, after delivery). Her BIOPSY REPORT given by the Dr.Lal Path lab, Delhi says Papillary Carcinoma,Microcarcinoma(occult) with two foci,tumour size 0.5cm*0.5cm,primary tumour pT1 limited to thyroid. Our surgeon Dr.(Prof.) Majeed Alam, M.S. F.R.C.S, has advised us for Total Tyroidtectomy within 6 to 8 weeks. Pl peruse and advise us the next course of action, as soon as possible, on my E-Mail Id.

Answered by Dr. Shailja Puri (46 minutes later)

Brief Answer: Total thyroidectomy is treatment of choice Detailed Answer: Hello, Thanks for posting your query on XXXXXXX The presence of cancer of thyroid (papillary carcinoma, microinvasive) is managed by surgery. A cancer of thyroid has high chance of spread to distant sites and after spread stage of the cancer increases. Papillary cell carcinoma of thyroid has good prognosis if treated early. Surgical removal of the thyroid will remove the cancer permanently from the body. Total thyroidectomy is the treatment of choice for papillary carcinoma of thyroid. After thyroidectomy, replacement of thyroid hormones is required in the form of thyroxine. Do not worry and go for surgery as soon as possible. If you have more queries, I will be glad to answer. Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shailja Puri (20 hours later)

Hiiii Thanks for the answer. Kindly tell me that after Total Thyroidtectomy, C.T.Scan with Radio Active Iodine is a mandatory protocol? Just imagine after left hemithyroidectomy,the biopsy report of my wife does not reflect any micro or papillary carcinoma,then can i avoid C.T.Scan with Radio Active Iodine? Because I am very much concerned about my breast feeding 3 months old little daughter.What are the side effects of C.T.Scan with Radio Active Iodine ? What are the Tests & check-ups one should follow after Total Thyroidtectomy ? Kindly also tell what are the precautions one should take after Total Thyroidtectomy ? What are the food/food products one should take and avoid after Total Thyroidtectomy?

Answered by Dr. Shailja Puri (4 hours later)

Brief Answer: Detailed answer is given below Detailed Answer: Hello and welcome again, The precautions after total thyroidectomy are same as in any other surgery- care of wound, avoiding infection and allowing sufficient time to recover. After total thyroidectomy replacement of thyroid hormones and parathyroid hormones is required. In thyroidectomy parathyroids are also removed along with thyroid. Since, there is evidence of micro invasive papillary carcinoma, the presence of carcinoma is sure. CT scan can be performed during lactation. Radioactive iodine can also be used during lactation. CT scan and radioactive iodine have to be avoided during pregnancy. CT scan causes exposure to radiation however, scan done for disease process will not have any deleterious effect. The therapeutic dose of radioactive iodine will not cause any serious side effect. Radioactive iodine is used to destroy cancer cells which may be left behind or if there is possibility of metastasis. If you have more queries, I will be glad to answer. Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (22 hours later)

Hello Madam, Thanks again for the answer. What are the Medical Tests & check-ups one should follow after Total Thyroidtectomy ? Kindly also tell what are the precautions one should take after Total Thyroidtectomy ? What are the food/food products one should take and avoid after Total Thyroidtectomy?

Answered by Dr. Shailja Puri (43 minutes later)

Brief Answer: TSH and parathormone levels need to be estimated Detailed Answer: Hello and welcome again, After total thyroidectomy, hormone replacement with thyroid hormones and parathormone is required. After starting the therapy, TSH and parathormone is required to look for deficiency of these hormones. If these hormones are deficient, dose of these hormones is required. No food items are to be avoided after the surgery. Thanks and take care Dr Shailja P Wahal

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Above answer was peer-reviewed by : Dr. Raju A.T