Is surgery a must

[Joseph106]

I have swelling in the right thyroid gland since last one year - it is not increasing; last week I met doctor for just a consultation and he asked to take an Ultra Sound Scan

The Scan report says:

Right lobe measures 3.06 X 2.44 X 1.63 cm
Left lobe measures 2.99 X 1.62 X 1.27 cm.
Istmus measures 3.1 mm.

Right lob shows multiple ill to well defined hypoechoic nodules, the largest measuring approx 12 X 5.8 mm. There is evidence of increase in vascularity in the right lobe as compared to left. An ill defined cystic lesion measuring approximately 14 X 8 mm is noted in the inferior aspect. Multiple small scattered calcific foci varying in size between 1-2 mm noted.
The left lobe appears normal in size and echotexture and shows normal vascularity.
A small right paratraheal lymph node varying in short axis diameter between 6-7 mm noted.

Visualized vessels appears intact.

Impression: Features suggestive of multinodular goitre

FNAC test was carried out immediately as per surgen's report:

Microscopy tells: all the three smears screened are:

Moderately cellular with thyroid follicular epithelial cells i8n sheets and clusters having uniform round nuclei. Cells with oncocytinc change also noted.
Background shows blood with minimal amount of colloid
No papillary process, nucear inclusions or grooves seen.

The surgen recommended total removal of the gland:

Is there any need of surgery at this stage? I am pre-medical student and have to study seriously now. Even if surgery is required, can I wait for 18 months (after the completion of my current classes and exams)

[stella5349]

I agree with Sally - this type of situation is all individually chosen based on the doctor and the patient.

I know people who have similiar situations that have waited years - and I know some who moved forward immediately

Keep in mind that even though you got a clear report of no pap being present - that does not mean its not there. FNAB's can miss cancer often and only a pathlogy after surgery is the tell all.

If you choose to put it off for a while and there is pap after the FNAB missed it - even through this is most likely an encapsulated cancer - things can happen and spread.

I suggest you go over the thyca.org site and read some - then take your findings to the surgeon or doctor to discuss this.

[Super_sally888]

Hi,

I think you should discuss with your surgeon whether it is wise to delay the surgery or not.

Usually recovery from this type of surgery takes a few months, not becuase of the surgery itself, which seems to be pretty straight forward in most cases, but becuase you will need to be adjusting thyroid meds after.... but with a vigilant dr. that shouldn't be too bad.

S