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Worried About My Biopsy Results Back As Having Papillary Carcinoma
Question: I've recently got my biopsy results back as having papillary carcinoma. It's about 2.1-2.3cm in size. I got an ultrasound because I was having pain when swallowing and also had pain in my cheek and couldn't chew solid foods without pain. Ent is saying they don't think its related to the thyroid cancer. I have also been having palpitations but my blood work shows normal thyroid levels. My main question is that I was given 3 treatment options 1) I can monitor it every 6 months 2) I can remove half my thyroid 3) I can remove the whole thing. I can't really decide ent said if it was smaller they would recommend just monitoring it n if it was bigger they would recommend removing but it's kind of on the fence I guess. I worry that removing the whole thing will leave me feeling strange for life like I could have more palpitations or racing heart rate but I like the idea they can be sure the cancer is completely gone with just a blood test. I also have mild cardiomyopthy and never been under general anesthetic but my sister has worse heart and did fine in surgery. Also I'm overweight and worried having it all removed will make me gain more which would be bad for my heart also. What do I do?
Brief Answer:
Please see the detailed answer below.
Detailed Answer:
Hi,
Thank you for the query on this platform. I can understand your concern. According to your FNAB of thyroid report has revealed that those cytomorphological changes may be found in papillary thyroid carcinoma or NIFTP.
NIFTP means non invasive follicular thyroid neoplasm with papillary like nuclear features that is a new name for a very low risk thyroid tumour previously known as an Encapsulated Non invasive Follicular Variant Papillary Thyroid Carcinoma.
From its name, it indicates that it is a low risk thyroid tumour and it is not malignant. It doesn't need any surgical intervention if it will become larger and cause complications in the near future.
Again, either it is papillary thyroid carcinoma or NIFTP, it is about 2.1-2.3 cm and your thyroid function test result is within normal level. As thyroid function test predicts the status of papillary thyroid carcinoma, so it is not essential for you to undergo a surgical intervention. Even, you don't need to take any thyroid medication too.
So, I think it will be better for you to monitor every 6months. If it will become larger, it will cause complications and your thyroid function will be changed, then you can consider for undergoing surgical intervention like partial or total thyroidectomy.
As your thyroid hormone levels are within normal range, so your racing heart or palpitations may not be resulted from thyroid problems. It may result from anxiety, stress, tension, lack of sleep or other causes.
Take care. Hope I have answered your questions. Let me know if I can assist you further.
Regards,
Dr. Zubayer Alam, General And Family Physician,
Please see the detailed answer below.
Detailed Answer:
Hi,
Thank you for the query on this platform. I can understand your concern. According to your FNAB of thyroid report has revealed that those cytomorphological changes may be found in papillary thyroid carcinoma or NIFTP.
NIFTP means non invasive follicular thyroid neoplasm with papillary like nuclear features that is a new name for a very low risk thyroid tumour previously known as an Encapsulated Non invasive Follicular Variant Papillary Thyroid Carcinoma.
From its name, it indicates that it is a low risk thyroid tumour and it is not malignant. It doesn't need any surgical intervention if it will become larger and cause complications in the near future.
Again, either it is papillary thyroid carcinoma or NIFTP, it is about 2.1-2.3 cm and your thyroid function test result is within normal level. As thyroid function test predicts the status of papillary thyroid carcinoma, so it is not essential for you to undergo a surgical intervention. Even, you don't need to take any thyroid medication too.
So, I think it will be better for you to monitor every 6months. If it will become larger, it will cause complications and your thyroid function will be changed, then you can consider for undergoing surgical intervention like partial or total thyroidectomy.
As your thyroid hormone levels are within normal range, so your racing heart or palpitations may not be resulted from thyroid problems. It may result from anxiety, stress, tension, lack of sleep or other causes.
Take care. Hope I have answered your questions. Let me know if I can assist you further.
Regards,
Dr. Zubayer Alam, General And Family Physician,
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
In the diagnosis section of my biopsy it says MALIGNANT- papillary thyroid carcinoma but in your comment you're saying it may not be malignant? My ent dr didn't really lean more toward observing she kind of just told me my 3 options.
Brief Answer:
Please see the detailed answer below.
Detailed Answer:
Hi,
Thank you for joining again. I have gone through your biopsy report for several times. Please read carefully my previous reply. I have told that according to your biopsy report, the cytomorphological changes are found which may result from papillary carcinoma and then added that " please note that some of these morphological changes can also be found in NIFTP." Please read carefully your biopsy report.
Your biopsy report has also advised that "please correlate with clinical impression". I have also mentioned about NIFTP, thyroid function test's value, treatment option in my previous query.
To assess your present clinical conditions and watch your biopsy report, your ENT specialist has provided you three options. If needed, then she has advised you to undergo surgical intervention as soon as possible and will never provide you three options.
As thre is presence of papillary thyroid tumour, so she has advised you to undergo surgical intervention like only operation of papillary tumor or total thyroidectomy to prevent any complications in the near future. Again, as your thyroid function test is normal, so she has advised to monitor the papillary tumor carefully.
I have just interpreted your biopsy report. So, it will be better for you to ask your ENT specialist why she has provided you three treatment options. You can also ask your pathologist to interpret his or her written cytopathological report.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Zubayer Alam, General And Family Physician,
Please see the detailed answer below.
Detailed Answer:
Hi,
Thank you for joining again. I have gone through your biopsy report for several times. Please read carefully my previous reply. I have told that according to your biopsy report, the cytomorphological changes are found which may result from papillary carcinoma and then added that " please note that some of these morphological changes can also be found in NIFTP." Please read carefully your biopsy report.
Your biopsy report has also advised that "please correlate with clinical impression". I have also mentioned about NIFTP, thyroid function test's value, treatment option in my previous query.
To assess your present clinical conditions and watch your biopsy report, your ENT specialist has provided you three options. If needed, then she has advised you to undergo surgical intervention as soon as possible and will never provide you three options.
As thre is presence of papillary thyroid tumour, so she has advised you to undergo surgical intervention like only operation of papillary tumor or total thyroidectomy to prevent any complications in the near future. Again, as your thyroid function test is normal, so she has advised to monitor the papillary tumor carefully.
I have just interpreted your biopsy report. So, it will be better for you to ask your ENT specialist why she has provided you three treatment options. You can also ask your pathologist to interpret his or her written cytopathological report.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Zubayer Alam, General And Family Physician,
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Above answer was peer-reviewed by :
Dr. Kampana
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