Aa
papillary carcinoma
Hello,
My husband(34 yrs) has done total thyroidectomy for thyroid cancer.Before surgery the CT scan report's FINDINGS are,
1.A well defined cystic nodule with a solid component is seen in the left lobe of the thyroid gland.It measures 2.8*3*5.5 cms.Few thin septae are seen in it.Following the administration of intravenous contrast the solid component shows dense enhancement to 100-120 H.U.The nodule is indenting the left jugular vein.
2.Few enlarged bilateral paratracheal and left deep cervical lymph nodes are seen.The nodes range between 8 and 10 mm in diameter.They show dense enhancement following the administration of intravenous contrast.
3.Few small lymph nodes showing mild enhancement are also seen in the submental,submandibular and deep cervical regions bilaterally.
4.The visualized sections of the lungs appears normal.
5.There is no mediastinal lymphadenopathy.
6.Mucosal thickening is seen in the ethmoidal and maxillary sinuses.
The REMARKS are,
1.Cystic nodule with an enhancing solid compenent in the left lobe of the thyroid gland.
2.Enlarged left deep cervical and bilateral paratracheal lymph nodes showing dense enhancement.
After surgery the pathology report says,The IMPRESSIONS are,
1.invasive papillary carcinoma,classical(usual)type,thyroid,left lobe,focally extending upto the inked capsular margin,total thyrodectomy.
2.Tumour size, greater dimension,1.5 cms.
3.Right lobe and isthumus with no specific lesion.
Now the Doctor is advicing to do both iodine-treatment and radiation therapy because of the lymph nodes and the point given in the pathology report like extended upto inked capsular margin.My doubt is,whether to do both the treatment or only iodine treatment,because the second opinion of my family doctor suggests that iodine treatment is enough for this case.So,please let me know the right procedure.
My husband(34 yrs) has done total thyroidectomy for thyroid cancer.Before surgery the CT scan report's FINDINGS are,
1.A well defined cystic nodule with a solid component is seen in the left lobe of the thyroid gland.It measures 2.8*3*5.5 cms.Few thin septae are seen in it.Following the administration of intravenous contrast the solid component shows dense enhancement to 100-120 H.U.The nodule is indenting the left jugular vein.
2.Few enlarged bilateral paratracheal and left deep cervical lymph nodes are seen.The nodes range between 8 and 10 mm in diameter.They show dense enhancement following the administration of intravenous contrast.
3.Few small lymph nodes showing mild enhancement are also seen in the submental,submandibular and deep cervical regions bilaterally.
4.The visualized sections of the lungs appears normal.
5.There is no mediastinal lymphadenopathy.
6.Mucosal thickening is seen in the ethmoidal and maxillary sinuses.
The REMARKS are,
1.Cystic nodule with an enhancing solid compenent in the left lobe of the thyroid gland.
2.Enlarged left deep cervical and bilateral paratracheal lymph nodes showing dense enhancement.
After surgery the pathology report says,The IMPRESSIONS are,
1.invasive papillary carcinoma,classical(usual)type,thyroid,left lobe,focally extending upto the inked capsular margin,total thyrodectomy.
2.Tumour size, greater dimension,1.5 cms.
3.Right lobe and isthumus with no specific lesion.
Now the Doctor is advicing to do both iodine-treatment and radiation therapy because of the lymph nodes and the point given in the pathology report like extended upto inked capsular margin.My doubt is,whether to do both the treatment or only iodine treatment,because the second opinion of my family doctor suggests that iodine treatment is enough for this case.So,please let me know the right procedure.
MEDICAL PROFESSIONAL
Iodine treatment (RAI) is radioactive (radiation) treatment - I would not think one would advise RAI and external radiation. I am not even convinced of the need for RAI as I did not see any mention of involved lymph nodes in the pathology report and postive margins (invasion) does not mean extension into the surrounding soft tissues. Also -- IF RAI is performed, 2 important points: 1) we are using lower doses than before -- sometimes as low as 30mCi and 2) if the CT of the neck was done w/ contrast, it is imperative to document low/normal urine Iodine prior to RAI.
IF there are any uncertainties, a second opinion from a thyroid expert with a good neck ultrasound exam would be worthwhile.
IF there are any uncertainties, a second opinion from a thyroid expert with a good neck ultrasound exam would be worthwhile.
Thank you Sir.But already we've taken ultrasound test.In that report it's given that,
Impression:
1.Well defined cystic nodule with echogenic solid component in the left lobe of thyroid gland.
2.Few prominent left level 2 and 3 nodes noted.(short axis size less than 10 mm).
Please give your feedback.
Impression:
1.Well defined cystic nodule with echogenic solid component in the left lobe of thyroid gland.
2.Few prominent left level 2 and 3 nodes noted.(short axis size less than 10 mm).
Please give your feedback.
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