Need more information

[MrsP08]

My endocrinologist just shrugs me off and mocks me when I ask him questions and tells him my concerns, so I am hoping to get more information about what is going on.

In 2006, a 1 cm cystic nodule was found on my thyroid.  A FNA was performed, blood tests were run and all came back normal.

In two years, this nodule has increased in size to 3 cm and is now solid. We discovered the nodule growth during an MRI for the arm and shoulder pain I'm having.  An ultrasound FNA was performed and more blood tests were run, and I should get results by Wednesday.

I know it's small, but when it is examined, I start gagging and came very close to throwing up during the FNA this week.  In addition, I have been having a lot of hoarseness, difficulty swallowing, increased irritability, and an almost impossible time sleeping that's been getting worse over the last few months.  My once manageable panic attacks now seem to rule me and I can never seem to relax.  My doc tells me its because my blood sugar is out of whack (Type II Diabetic) although my readings are low and my last a1C was a 4.2.

I understand that nodules grow and it doesn't mean anything, but is it okay that they go from a cyst to solid?  What is going on? I'm not worried about cancer, but I don't understand why it's changing so much so quickly.

[898]

This is the first post I read about transformation of the benign cystic to solid nodule; I can speculate that the cyst was complex at the first place, so the solids build up inside and caused it to appear solid. You may have to find different endo, as rapid increase in nodule size and change of its composition calls for more investigation including the high –frequency sonogram with Doppler color flow.
The RAIU scan may be necessary as if nodule takes up iodine it can be RAI ablated otherwise surgery may be necessary.

[Mark Lupo, M.D.]

It likely was not a cyst to solid transformation but growth of a mixed solid/cystic lesion as mentioned by 898 above.  If it is causing pressure symtpoms, then it may need more aggressive treatment.  Once it's proven benign by FNA then an i-123 scan could be done to see if RAI may help -- it helps sometimes (60% of time) to reduce the nodule by up to 40% if there is good uptake, but a skilled surgeon is often preferable.  The other symptoms (panic, etc) are not likely related unless you are worrying about the nodule or the nodule is over-producing thyroid hormone (checking TSH to make sure levels are okay would be advised).