I was just diagnosed with a 2mm papillary thyroid carcinoma with follicular growth pattern. I had a total thyroidectomy, not expecting to find cancer. The focus was confined to the thyroid. The right lobe shows a stitch at the superior pole. What does "stitch" mean? No one explained it to me and the significance. I was wondering if it meant, the cancer was close to escaping, close to not being contained with in the thyroid gland. Kind of like a pull on the gland.
If there is Papillary thyroid cancer anywhere in the neck, outside the thyroid, the minimal surgery is total thyroid removal and central compartment dissection. The next issue is a careful ultrasound evaulation of the rest of the neck to determine if lateral neck dissection is needed.
The rock-hard L lobe is very concerning as the possible "primary" tumor.
Rare intranuclear inclusions or nuclear grooves alone in an otherwise benign specimen is probably not papillary thyroid carcinoma. CK19 (cytokeratin 19 - a strong staining of cell blocks) aids in accurate diagnosis of malignancy in uncertain cases. These two studies go into more detail...
"When fine-needle aspiration biopsy cannot exclude papillary thyroid cancer: a therapeutic dilemma" - Arch Surg. 2006 Oct;141(10):961-6; discussion 966.
Normal appearance of pulmonary vessels and thoracic aorta. No pericardial effusion or pleural effusion. Visualised thyroid lobes appear normal. Mild thoracic spondylosis changes. No significant focal bone lesion.
Impression:
Large calcified mass between chondral regions of righ 3rd and 4th ribs. No clear plane with sternum and pleural. differential diagnosis includes calcified chondroma, chondrosarcoma, fibrous displasia or calcified pleural mass.
s worth - I had the remaining half of my thyroid removed after my first surgery showed papillary carcinoma (and the rest of my family also had papillary carcinoma). I had a recurrence three years later. My Tg rose slightly (3x higher in six months) and my TSH continued to climb. I had 100mCi and, yes, it was a cancer recurrence. My sister has had to undergo RAI three times because of metastases and recurrences.
Hi siril,
I'm sorry your boyfriend is going through this. I am a papillary thyroid cancer survivor. Brief history:
First diagnosed 1985
Total thyroidectomy, some lymph nodes removed
Radioactive iodine ablation 1985
Persistent disease, 2nd radioactive iodine 1986
Recurrence 2008
Surgery, 3rd radioactive iodine 2008
Further cancer detected 2009....
Do the lymph nodes usually swell after thyroid surgery?
My complex nodule (yes, fluid and solid) was only 5mm but was cancerous. Yes, complex is a bit more worrisome but not a cancer diagnosis.
Even if the FNA is inconclusive or benign, don't ignore the nodules. Two of my sisters had complex nodules and benign FNAs but both had cancer. You will need to keep a close eye on these nodules.
Please keep us posted!
A year later (because of family diagnoses of papillary carcinoma) I decided to have the left lobe removed which was completely free of nodules or cancer. Two years after the 2nd surgery I had a recurrence in the thyroid bed (and some in the liver). Even though the original cancer was small and encapsulated microcancers regrew in the remaining thyroid tissue.
If cancer is suspected a complete thyroidectomy (with possible RAI) is the standard course of action because of the microcancers.
papillary, follicular (including Hurthle cell), medullary, and anaplastic)
Following surgery, papillary and follicular are treated one way (with radioactive iodine) and medullary and anaplastic are treated very differently - usually with external beam radiation (since they are NOT made up of thyroid tissue and do not absorb iodine).
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