Nodes and Neck Dissection

[MNC]

History:
Rt. Lobectomy 04/06
Pap Car
Lft. Lobectomy 04/06
Multifocal Pap Car
RAI 100mCi (LID, thyrogen, & off meds) 05/06
WBS normal uptake in neck area 05/06
Stimulated Tg 1300 05/06
TSH .60 on 137mcg Synthroid
Unstimulated Tg 64 06/06
Unstimulated Tg 42 10/06
WBS (LID & thyrogen) uptake in several lymph nodes (rt. side of neck) 11/06
U/S - at least 7 nodes over 1cm 11/06
U/S FNA - endo surg took 2 samples - no results yet

Endo Surg says I need a Neck Dissection. Is this normal protocol? -OR- Is it possible that RAI may work?

Thank you for your time.
MNC

[Mark Lupo, M.D.]

Thanks for the detailed presentation.  I assume you are Tg-Ab negative.  The unstimulated Tg is falling but still quite high.  The RAI was at least partially effective.  What was the post-Thyrogen Tg in 11/06?  I know it is high, but just curious to compare to the 5/06 1300 level (ie before the RAI took effect).

I tend to favor neck dissection over more RAI in most cases of US detectable disease.  I doubt the 5/06 RAI will be adequate to eradicate the persistent disease and avoid another surgery.

By LID, do you mean lithium?  Where are you being treated - just curious - that is a protocol used frequently a few hours north of me....(and in other places as well)

[MNC]

post-Thyrogen Tg in 11/06 was 860. By LID, i meant Low Iodine Diet. I am being treated at Vanderbilt in Nashville, TN.

Thank you for the information.
MNC