Thyroid Symptoms After R.i. Posted: 08-31-07 11:49am
My 39-year old daughter noticed a thyroid
nodule after the birth of her son six
years ago. She had a needle biopsy at that
time and a second biopsy two years later.
Both were benign. She continued to have
symptoms sporadically and had an
ultrasound two years ago that was normal.
In December 2007 she started having more
severe symptoms –constant neck pain,
swelling, hoarseness, tired, etc., and
finally had a tyroidectomy in April 2007
(no lymph nodes were removed). There was
2cm cancer on the right and less than 1cm
on the left. She has Tall Cell variant.
Before her R.I. treatment the uptake
showed a “hotspot” to the right of her
thyroid. This is the exact area where she
continues to have pain that radiates to
her ear. She feels soreness, fullness, and
can feel a lump (far back). One doctor
said it was slightly palpable (this was
before her surgery), but the surgeon
currently treating her cannot feel
anything. Yet, she feels that something is
there and she is symptomatic, as she was
prior to the surgery. She had a CT scan
this month (August 2007) that was clear,
and the ultrasound before the R.I.
treatment was clear. Should she still be
concerned, get a second opinion? Is there
better imaging, like a PET scan? How
accurate is the CT scan? I am very
concerned since all of her tests prior to
surgery were “normal” but she actually
did have cancer, so we not as reassured as
we would like to be based on the CT scan.
Also, I know that tall cell variation is
more aggressive. I would appreciate any
feedback. Thank you.
T’s mom
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MandMs
Extremely EHEALTHy
Joined: 26 Jan 2007 Posts: 1881 Location: Strumica, Macedonia
Thanks: 21
Thanked:10
Posted: 09-04-07 04:57am
Hi!
I'm very sorry that your daughter went
through such a bad experience!
I'll suggest you to have second opinion
knowing that this type of cancer has
bigger recurrence and is more aggressive.
Usually, most of the early stages of
thyroid cancer aren't associated with any
symptoms. There is a occult type of cancer
one that is often less than 1 cm in
diameter, impalpable, incidentally seen on
surgery and rarely visible on thyroid
scans. That kind of changes can be
detected on ultrasound but can't be
distinguish between malignancy and
benignity. CT and MRI are determining the
extent of the change but also can't
separate benign from malignant lesions.
Biopsy is the most important test, which
success depends on a skillful aspiration
technique and an experienced
cytopathologist. You should know that
there are information that say 60% of
nodules interpreted as suspicious are
found to be malignant on thyroidectomy.
I think that PET scan can be very helpful
in early detecting recurrence and getting
proper treatment.
Hope I helped!
Last edited by MandMs on 09-05-07 07:50am; edited 2 times in total
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Richard Day Gore
New User, Becoming EHEALTHy
Joined: 22 Nov 2006 Posts: 48
Posted: 09-05-07 04:37am
Defintiely get a second opinion, if not a
third one. And please keep us posted.
Best regards,
Richard Day Gore
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danielv
Experienced User , Rather EHEALTHy
Joined: 03 Jul 2003 Posts: 68 Location: South East, Macedonia
Posted: 09-05-07 06:26am
how are her calcium levels? elevated
levels of calcium (even slightly) may
indicate problems with the parathyroid
gland. The parathyroid glands are small
glands located directly behind the
thyroid.
Make sure that her endocrinologist checks
these as well.
These "hot spots" may probably be saliva
gland uptake of RAI. If she's having
pain, it may be a saliva gland that is
damaged. You need to query her about
wheter or not she has dry mouth or dryer
than usual and whether or not she is
getting ulcers in her mouth more
frequently. This happened to me after
RAI. I got on Biotene Saliva replacement
gel, toothpaste, and mouthwash. It's been
a year and a half for me since RAI, but
I'm still having some saliva gland
problems, but it's much better than it
was. By the way, PET scans are efficient,
but the dose of radiation that you get
from it isn't worth it to me. Ultrasound
is still the best modality to me,
personally.
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