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What Causes Swelling In Front Side Of Neck?
Question: I am 28 years female with no medical health problems till now. I have observed a swelling in the front side of the neck and performed the following tests:
T3 Triiodothyronine - 0.90
T4 Thyroxine - 9.60
TSH - 4.78
I have performed high resolution sonography of thyriod and Cytopathology report as well. By looking at the reports doctor has confirmed that it is hashimotos Thyrioditis with follicular neoplasm and suggested for additional CT scan to observe the condition. However, it is suggested to remove the thyriod gland.
When i have asked the specialist last time in Ask Doctor, doctor has suggested another review with expert pathologist. Please see the attached FNAC report. AS the report was reviewed with expert endocrinologist and a Thyriodectomy is suggested.
T3 Triiodothyronine - 0.90
T4 Thyroxine - 9.60
TSH - 4.78
I have performed high resolution sonography of thyriod and Cytopathology report as well. By looking at the reports doctor has confirmed that it is hashimotos Thyrioditis with follicular neoplasm and suggested for additional CT scan to observe the condition. However, it is suggested to remove the thyriod gland.
When i have asked the specialist last time in Ask Doctor, doctor has suggested another review with expert pathologist. Please see the attached FNAC report. AS the report was reviewed with expert endocrinologist and a Thyriodectomy is suggested.
Brief Answer:
Thyroidectomy is needed
Detailed Answer:
Hi,
Welcome back.
The second opinion on FNAC is also follicular lesion. Follicular lesion can be differentiated to follicular adenoma (benign) or follicular cancer only by surgical removal and biopsy.
So even though your report of follicular lesion is not cancer, you need to do thyroid surgery to confirm it is benign or not.
Hope I have answered your questions. If you have any further queries I will be happy to help you
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Thyroidectomy is needed
Detailed Answer:
Hi,
Welcome back.
The second opinion on FNAC is also follicular lesion. Follicular lesion can be differentiated to follicular adenoma (benign) or follicular cancer only by surgical removal and biopsy.
So even though your report of follicular lesion is not cancer, you need to do thyroid surgery to confirm it is benign or not.
Hope I have answered your questions. If you have any further queries I will be happy to help you
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Ajish,
Thank you for the quick response.
I have below questions after you have suggested thyriodectomy.
1. Should we go for Lobectomy, subtotal thyriodectomy or Total Thyriodectomy, based on the FNAC report that i have attached.
2. After we go with this surgery, will there be any side effects after surgery like hypothyriodism(as gland is removed), or will it affect metabolism or will it affect the fertility as there is plan for second kid?
3. How many days rest is required after the surgery for a person to go back to usual activities?
4. there are 2 risks mentioned for this surgery in few articles like damage to parathyriod glands or recurrent larygneal nerves?
Thanks,
XXXX
Thank you for the quick response.
I have below questions after you have suggested thyriodectomy.
1. Should we go for Lobectomy, subtotal thyriodectomy or Total Thyriodectomy, based on the FNAC report that i have attached.
2. After we go with this surgery, will there be any side effects after surgery like hypothyriodism(as gland is removed), or will it affect metabolism or will it affect the fertility as there is plan for second kid?
3. How many days rest is required after the surgery for a person to go back to usual activities?
4. there are 2 risks mentioned for this surgery in few articles like damage to parathyriod glands or recurrent larygneal nerves?
Thanks,
XXXX
Brief Answer:
please see detailed answer
Detailed Answer:
Hi,
Welcome back.
The answers to your questions
1. The option is either a total thyroidectomy or hemithyroidectomy ( half of the love is removed). This you have to discuss with your surgeon. There are pros and cons for both procedures.
If the ultrasound is showing normal thyroid gland on the other half, some surgeons prefer hemithyroidectomy. The advantage is that, you need not be on thyroxine supplementation after that and surgical complications are less. Disadvantage is that if the Hemithyroidectomy histopathology report comes as cancer, you need to have a second surgery to remove the remaining half of thyroid immediately. You can develop a second tumour some times later, and repeated surgeries are associated with more complications.
2. After total thyroidectomy, you will be hypothyroid. But with thyroid hormone replacement treatment, you can have a normal delivery without complications.
3. You can be discharged from hospital on 3rd to 5 th day and resume normal activities after that. You can return to work after 1 week.
4. These are 2 risks involved in surgery - can be seen in 3-10% of cases. Depends on surgeons expertise.
Regards
Dr Ajish TP
please see detailed answer
Detailed Answer:
Hi,
Welcome back.
The answers to your questions
1. The option is either a total thyroidectomy or hemithyroidectomy ( half of the love is removed). This you have to discuss with your surgeon. There are pros and cons for both procedures.
If the ultrasound is showing normal thyroid gland on the other half, some surgeons prefer hemithyroidectomy. The advantage is that, you need not be on thyroxine supplementation after that and surgical complications are less. Disadvantage is that if the Hemithyroidectomy histopathology report comes as cancer, you need to have a second surgery to remove the remaining half of thyroid immediately. You can develop a second tumour some times later, and repeated surgeries are associated with more complications.
2. After total thyroidectomy, you will be hypothyroid. But with thyroid hormone replacement treatment, you can have a normal delivery without complications.
3. You can be discharged from hospital on 3rd to 5 th day and resume normal activities after that. You can return to work after 1 week.
4. These are 2 risks involved in surgery - can be seen in 3-10% of cases. Depends on surgeons expertise.
Regards
Dr Ajish TP
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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