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benign multiple nodules with calcification


I am female 41 years old. on my routine check up I found out that I have fatty liver and in an early stage of diabetes. my cardiologist referred me another doctor (endocrinologist). I had an ultrasound ordered by my endocrinologist and we found 8 nodules on my left thyroid and 3 of them big the biggest size is 2.19 X 2.80 X 2.13 with calcifications.  on my left thyroid there are 6 nodules, 2 of them big and the biggest size is 1.81 X1.66 X1.44 cm. My doctor asked me to do an ultrasound with guided biopsy.

I have 14 nodules and the pathologist got a sample on the biggest nodules on my right thyroid lobe. the results we benign.

My doctor told me that i have to closely monitor these and will have biopsy every 3 to 6 months for now. if there will no growth or no new nodules then I have to do it once a year.

the other option is to get surgery and take them all out. i am worried because there are too many of them and I don't think I can have biopsy in all 14 of them. i am thinking that i should get the surgery.

Is this the right thing to do? if I do the surgery what are the chances of these nodules of growing again? is there going to be a lot of medication after the surgery?

would appreciate your professional advise.

thanks
3 Responses
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97953 tn?1440865392
MEDICAL PROFESSIONAL
This is multi-nodular goiter.  The key here is working with a doctor who does his/her own ultrasound who is able to determine which nodules are suspicious and need biopsy.  The larger one with calcifications needed FNA.  Most of these are benign and can be followed but if there are pressure symptoms or continued growth, then surgery may be reasonable.  Insulin resistance (your early diabetes and fatty liver) is a risk factor for thyroid nodules like this and possibly an increased risk for thyroid cancer, but not enough to go straight to surgery.
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Avatar universal
Thank you for your advise.

What is FNA? The nodules that was biopsy'd was the biggest one because they cant biopsy all the 5 big ones.

I am taking metformin 500 mg once a day for my diabetes. if i belong to a risk for thyroid cancer isn't that reason enough to go to surgery? if not, what should I do?

appreciate your advise.

Thanks,

Marifi
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Avatar universal
FNA is 'fine needle biopsy.'  I had this done on nodules found on my thyroid. The procedure for me was not painful and I did it without lidocaine. Four aspirations were taken and cell 'suspicious for follicular neoplasm' were discovered. The only alternative offered was surgery, which was removal of the thyroid lobe on which these nodules were present. It's not possible to take just the nodule, as they are 'vascular,' meaning too much circulatory interaction between the nodule and the thyroid tissue itself.
  They did a PT (partial thyroidectomy) and removed the right thyroid. Pathology report then came back benign. I have several small nodules on my left thyroid lobe, but for now, nothing is to be done with those.
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