:( ultra should showed thyroid tissue (could be cancer)

just got a call from my endo. so 4 month post RAI, my Tg dropped from 26 to 7, which is not low enough, remnant is suspected. and ultra sound prooved it today. it's a 2 X 1 cm thyroid tissue in the center of thyroid bed( alittle to the left of breathing tube). and we are not sure if it's cancer.

two option:
1. wait 6 weeks to test Tg again to see if the RAI is still actively working.
2. go ahead re surgery. :(

any comment,, suggestions?

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they can't do an FNA?

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yes, Jani, endo wants me to discuss with my surgeon about FNA options. I guess I want that done first before deciding. wondering how long this can wait. I just wish the 125mci I131 can keep destroying it. it's uncertain game now :(

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in your position, I would push for the FNA and a more detailed ultrasound going over the exact description/characteristics of the tissue. also, I would get my surgeon involved in the discussion.

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thank you Jani! I am copy pasting your exat words to my endo...he is nice enough to respond to my message after 5pm right now ...I was crying just now and asked him if my prognosis is going to change, he said "overall prognosis remains excellent simply because you have stage 1 (ie. Less than 45 years old, no known distant metastases)"...Hope he is right...but that made me happy ...

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good :))

good thoughts to you!!

i hope they get it figured out quickly enough and happy to read you are feeling a bit happier/optimistic.

whatever it is, they'll zap it! :))

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Hugs to you Jani...I really appreciate your input and help... :))

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Wish you the best :)

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In addition to an FNA, I'd at least ask about an MRI.

If it were me, I'd be a bit leery of a CT scan because the contrast they use for MRI is non-iodine based while the contrast for CT scan is often iodine based.

As much as I hate the idea of an additional surgery, I hate the idea of leaving that potential cancer there even more; hence, the FNA first. But, as you know the FNA may not be the walk in the park the first one was. You're talking about trying to hit a 2cm by 1cm tiny dot with a needle using an ultra sound as a guide. I'd at least ask for radiologist with the best track record of hitting something that small - I'm not sure I'd let an endo do it in their office - I'm not sure I wouldn't let them, just saying I'd want the absolutely most experience ultra sound guided FNA expert within a 100 mile range to be in charge.

Also, if you don't have it, before that FNA, get them to Rx xanax or ativan. Seriously, "well tolerated" means it doesn't hurt the doctor.

Good luck.

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RAI takes time to work - up to six months - sometimes even a year. It depends on dosage and preparation and how high your TSH was.
If I were in your shoes, if I prepped with the LID and had a TSH of over 100 when the RAI was given, and if I had over 100 millicuries, I'd likely opt for watchful waiting. If the LID was not used and TSH was lower and if a lower dosage was given, I'd push for the FNA. If the FNA shows normal tissue, then you might want to ask about doing RAI again vs. another surgery - either should work depending on how much is there.
I had to have a second surgery...not fun, but it did the trick and I'm cancer free 16 years later.
Be well,
dj

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I have the same situation! TT Oct. 2011, RAI Jan. 2012, I'm stage 2 solid variant papillary thyca..... 6 month ultrasound after RAI showed .5cm nodule in right thyroid bed, radiologist report says... Could be left over thyroid tissue or could be recurrent disease. So..... Since my TG is undectable but my TgAB is positive..... I'm in a watch and wait mode for 6 months.... Not happy about not having a clean scan, but I guess I'm waiting......UGH

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same thing with me, after 6 month check up ultrasound showed nodule in left thyroid bed. waited another 6 months did 3D ultrasound showed a scar tissue. I wish you the best!

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TopOverU, thank you. I will check with my Doc with my endo. not sure why my endo never mentioned it?

I looked up these two drugs: xanax or ativan. they are for anxiety. I actually didn't experience anxiety except post my TT very briefly. the only sympton was "short of breath". but I never had any of that later on. that's what you suggesting right? or are these drugs related to FNA?

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DariaJ, thank you!

I did have 125 mci radioactive iodine...and I did LID as well. for 10 days. prior to my RAI (is that enough?)

and I don't know my TSH, because I was using thyrogen...Dr says its garuanteed to raise my TSH to a high level.

do you think 3 month and a half post RAI dropping my Tg from 26 to 7 is showing it can continue to drop? I will find out soon in a week when I do the Tg again. I did my last Tg 4 weeks ago.

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Well, you had a good dose of RAI, and you prepped with the LID. I think I'd watch and wait with frequent ultrasounds. Tg will first go up as RAI kills tissue then should drop and keep dropping. It can drop for up to a year.
Have faith, do your homework and you'll decide what the right course of action is...for you.
Reach out any time.
dj

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thank you dariaJ..(thanks to all members who replied , I forgot to)

just saw my US report, pasted below: in short, the tissue found was suspicious for cancer. ;((

1. Ill-defined heterogeneous solid soft tissue within the left
thyroidectomy bed demonstrating hypervascularity and punctate
echogenic foci, suspicious for residual or recurrent thyroid
carcinoma.

2. no suspicious nodes.


I think my case was definitely residue, instead of recurrent. I don't know how the surgeon missed it...it's not part of the tumor (4.5 cm), and the pathology report said the tumor was intact, only invaded the capsule, and partially capsuled. outside the tumor capsule, is benigh thyroid tissue, outside the thyroid gland, is negtive margin.


surgeon did mention he replanted one parathyoid back in me after checking it's good.


will do FNA in 10 days...so will know if the tissue is cancer or not in 15 days.

Dr says if it's cancer, regardless of my Tg trend, he recommend to remove it by surgery. which I agree...

urrrrggggg...not a easy ride , huh?

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dr. says we can't rely on radioactive iodine to kill cancer...that s why it's recommended to do surgery.

if it's not cancer, then makes sense to wait and watch.

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