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Thyroid and nodule increasing in size...concerns and removal?
I have had a thyroid nodule that has continued to increase in size over the past four years and most recent growth from January to June has been highest increase, I have requested it to be removed but that request has been dismissed by my provider. I am wondering if I should continue to press for removal as my concerns continue to increase. I have had RAI Uptake scans and multiple biopsies (five from 2014-present) and routine US from 2014-2018.
The nodule is solid, previous biopsies have been...inconclusive or a bethesda score of 1 (2014) or 2 (2017). 24 hr uptake scan (2017) came back at 21% with the scan images demonstrate minimal inhomogeneity of tracer distribution throughout the gland.
Most recent US results (June 2018)
COMPARISON: 1/9/2018.
TECHNIQUE: Grayscale and color Doppler imaging of the thyroid gland was performed.
FINDINGS:
-Right: The right thyroid lobe is enlarged and heterogeneous in echotexture measuring up to 5.6 x 2 x 2.1 cm in greatest longitudinal, AP and transverse dimensions respectively. Again there is a dominant solid nodule in the mid to lower pole which measures up to 2.6 x 1.2 x 1.9 cm. On the previous exam this measured up to 2.2 cm. The entire right thyroid lobe on the previous exam measured 5.1 cm. There is increase in color flow and vascularity throughout the thyroid nodule with normal vascularity throughout the entire right thyroid lobe.
-Left: The left thyroid lobe is at the upper limits of normal size measuring 4.3 x 0.9 x 1.4 cm. There is normal color flow and vascularity with no solid or cystic nodule identified. The isthmus is within normal limits measuring 1.5 mm. Previously the left thyroid lobe measured up to 4 cm.
IMPRESSION: INCREASING SIZE OF A DOMINANT RIGHT THYROID NODULE ON TODAY'S EXAM, IT NOW MEASURES UP TO 2.6 CM COMPARED TO 2.2 CM ON THE PREVIOUS EXAM. IT IS SLIGHTLY HYPERVASCULAR AS WELL.
The nodule is solid, previous biopsies have been...inconclusive or a bethesda score of 1 (2014) or 2 (2017). 24 hr uptake scan (2017) came back at 21% with the scan images demonstrate minimal inhomogeneity of tracer distribution throughout the gland.
Most recent US results (June 2018)
COMPARISON: 1/9/2018.
TECHNIQUE: Grayscale and color Doppler imaging of the thyroid gland was performed.
FINDINGS:
-Right: The right thyroid lobe is enlarged and heterogeneous in echotexture measuring up to 5.6 x 2 x 2.1 cm in greatest longitudinal, AP and transverse dimensions respectively. Again there is a dominant solid nodule in the mid to lower pole which measures up to 2.6 x 1.2 x 1.9 cm. On the previous exam this measured up to 2.2 cm. The entire right thyroid lobe on the previous exam measured 5.1 cm. There is increase in color flow and vascularity throughout the thyroid nodule with normal vascularity throughout the entire right thyroid lobe.
-Left: The left thyroid lobe is at the upper limits of normal size measuring 4.3 x 0.9 x 1.4 cm. There is normal color flow and vascularity with no solid or cystic nodule identified. The isthmus is within normal limits measuring 1.5 mm. Previously the left thyroid lobe measured up to 4 cm.
IMPRESSION: INCREASING SIZE OF A DOMINANT RIGHT THYROID NODULE ON TODAY'S EXAM, IT NOW MEASURES UP TO 2.6 CM COMPARED TO 2.2 CM ON THE PREVIOUS EXAM. IT IS SLIGHTLY HYPERVASCULAR AS WELL.
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