II Am A 68-year-old Male. In November Of 2018, About

Posted on Thu, 18 Jun 2020

Question: II am a 68-year-old male. In November of 2018, about a year and a l half ago, I noticed a small lump on my throat that was sensitive to touch. My primary care physician arranged for an ultrasound on my thyroid and I was told that I had benign nodules or cysts and that the ultrasound should be repeated every six months. Since then, all ultrasounds have shown no change… until the one I had last week. Apparently, it shows some growth so I’m being referred to an endocrinologist.

My father was diagnosed with a thyroid problem when he was in his 40s. and had his thyroid removed. I don’t recall the diagnosis, but he lost a lot of weight so I think it was probably hyperthyroidism. Also, my sister had hypothyroidism in her 20s and ELECTED to have her thyroid removed. She is 67 now and has no lingering issues.

My concern, of course, is a diagnosis of cancer. I realize you can’t tell me with certain what is going on with me, but I confess that I am a worrier so any thoughts you have on the matter will be much appreciated.

Also, I have attached my medical records.

Answered by Dr. Mirjeta Guni (44 minutes later)

Brief Answer:
About thyroid nodules;

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern and attached lab exams.
First i would like to inform you that thyroid nodules are a very common pathology (1 in 2 persons at your age has thyroid nodules) , a small percentage of them are malignant ( 3%) and the tendency of the nodules during the life is to get increased.
So the increased dimensions at the last ultrasound examination is not the main criteria to decide for FNA.
Other ultrasonographic criteria should be evaluated.
You didn't attach any ultrasound report, so i could have a better idea and give you a more specific answer.
If you have any ultrasound report please do not hesitate to attach.
Will be a pleasure to help you further.
Best wishes,
Dr. Mirjeta

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mirjeta Guni (1 hour later)

Dr. Guni,

Thank you for your prompt reply. Following your response I obtained a copy of my ultrasound and have uploaded it on your system. Please let me what you think about it.

Thank you, XXXXXXX XXXXXXX

Follow up: Dr. Mirjeta Guni (21 hours later)

Dr. Guni,

Just checking to see if you received my followup message and the copy of my ultrasound record yesterday.

Regards, XXXXXXX XXXXXXX

Answered by Dr. Mirjeta Guni (1 hour later)

Brief Answer:
about thyroid nodules;

Detailed Answer:
Hi again,
I have gone through your ultrasound report.

The nodule has ultrasonographic criteria that classify it as suspicious for malignancy ( as described by the radiologist).

So, it is not only the increased dimension but has other characteristics ( irregular margins, hypoechoic) that make it a candidate for cytology.

There is no need to get worried as still the chances for malignancy are not high (has suspicious characteristics, not typical criteria). So you need to do FNA.

Furthermore, thyroid malignancies are curable with a thyroidectomy in most of the cases.

Wishing you good health.
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee