Thyroid Problems/Goiter and nodules

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QUESTION: 2 years ago I had a scan of thyroid which showed several nodules on both lobes. 3 of them were biopsied but there wasn't enough taken during the FNA to tell if they were cancer so I went somewhere else to have the FNA nd the results were non cancer. In a year and a half later I had another scan and they and my thyroid have grown to the following:rt thy lobe-8.1x3.5x4.9 cm in size and left thy lobe -9.6x3.7x5.9cm. there are numerous nodules scattered throughout lobe. The largest is 4.4cm. left contains many nodules 27mm, 19mm and 13mm in diension...nodules in right lobe 22, 18, 17 and 22 in greatest diameter. thyroid isthmus is thickened 19 mm in anterior to posterio deminsion. This is some growth from almost 2 years ago. I do not want surgery. He is going to do another FNA. Is there anythng to stop growth other than surgery. Wht is your advice?

ANSWER: Cat,
My advice is since there is no malignancy, you can intially try radioactive iodine therapy. But ultimately you will need to go for total thyroidectomy(surgey) after completion of the RAI therapy. You need to understand that To avoid the consequences of goitre, any doctor will recommend a thyroidectomy. After the surgery you will be perfectly healthy n will need to take thyroxine supplement daily. But your health will become completely stable. Right now you can request your doctor to postpone the surgery, but one or the other day you will need to get it removed. Let me know after the FNA is repeated. I will guide you what to do. Please send any lab reports if you have next time.

Thanking you!

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---------- FOLLOW-UP ----------

QUESTION: What will the RIT do for me? I do not want surgery as I have several health issues including pulmonary hypertension and don't feel this woud be a safe surgery for me. I m not having trouble with breathing or swallowing right now. How long before the surgery would be inevitable? It seems to grow slowly if this FNB returns a benign result as well

Answer
Cat,
RIT will gradually destroy thyroid cells. It will help reducing the goiter. But if it is not satisfactory or if the goiter relapse after RIT then you will need to go for surgery. When they perform surgery is actually decided by the surgeon. But it also depends on how successful RIT treatment turns out to be. But in my opinion you can wait for maximum 1 - 2 year. If it puts pressure on neighbouring structure then you need to get it removed early. Anyway let us wait till latest FNA reports come.

Thanking you!


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Thyroid Problems

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Dr.Shrinidhi Kulkarni

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