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Cancer > Thyroid Cancer Forum > Thyroid Symptoms After R.i.
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Q: Thyroid Symptoms After R.i.
asked by: Concerned mom22 on August 31st, 2007
New User
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
replied on September 4th, 2007
Extremely eHealthy
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!
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Richard Day Gore
replied on September 5th, 2007
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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
replied on September 5th, 2007
Advanced Support Team
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.

http://www.parathyroid.com/parathyroid-sym ptoms.htm

Best wishes,
~Daniel
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Tasman Bay Butterfly
replied on April 19th, 2008
New User
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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