2 x non diagnostic FNA biopsies, highly suspicious nodule. Need information please.

FormerMember
FormerMember
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Hi all

I'm new here, and really thankful to have found this forum. Reading some of your posts has provided a lot of helpful information.

I'm currently going through diagnosis and looking for some information about what the best course of action for me is.

I noticed a tender lump on the right side of my neck which turned out to be a 4cm cluster of nodules covering entire right lobe of thyroid which ultrasound classified as TR4 suspicious (the private hospital I was referred to uses TIRADS) but the FNA was THY1 non diagnostic. I had a repeat ultrasound and FNA a week later, and the nodule is now classified as TR5 highly suspicious but FNA still THY1. I don't know if there's been a change in size, the doc seems reluctant to provide too many details and I forgot to ask at my last appointment.

My ENT (thyroid specialist) says next step is hemithyroidectomy. He thinks a repeat FNA will probably come back as THY1 non diagnostic again.

I have a general distrust of doctors because of a few bad experiences, so I always feel like I have to do my own research until I feel comfortable that the advice is what's best for me.

I have two worries.

One is that they remove half my thyroid and it turns out to be benign. I worry about this because I've struggled my whole life with low energy and never feeling rested after sleep despite normal thyroid function tests. I don't know how I'd cope with life if I felt worse than I already do.

The other worry is that if it's malignant I'd have to go for a second surgery to remove the remaining half. I'd rather have the whole thing removed in one go if it's malignant.

The BTA guidelines say recommended action for THY1 result is repeat FNA. I can't find information on what normally happens if the repeat FNA is also THY1.

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Has anyone had two THY1 results on suspicious nodule and taken a different course of action for diagnosis other than surgery?

Anyone here who had low energy before having their thyroid out? How did you feel and cope afterwards?

Any other relevant information you can share will be greatly appreciated.

  • The second most common type of thyroid cancer cannot be definitively diagnosed without removing the lump. Therefore, a lot of us have been in your position. Basically, anybody who has had follicular TC (and some with other types - since FNA isn't perfect even for Papillary) have gone through hemithyroidectomy.

    It is what it is. They can test you again and again until the cows come home and not get a conclusive test if that's what you've got - or if you've got nothing at all.

    So my advice is to bite the bullet and get it out. Better to know one way or another.

    In my case it was cancer.

    In the case of my sister, hers was just 'a boring old lump'. She's been living on half a thyroid ever since and doesn't take any thyroxine.

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • FormerMember
    FormerMember in reply to barbaral

    Thank you barbaral, that's helpful to know. 

  • I know it can be really hard to believe in these days of super-clever advanced diagnostics that the most reliable way to find out is to cut it out and have a good look.

    I have seen some reports of genetic profiling of lumps - forgive me, I forget the name of the process - that seems to be becoming more available in the USA but I honestly don't think we're seeing that done in the UK just yet.

    Generally speaking, if you've got a lump, it rarely seems to go away of its own accord. It can stay small for a long time or go on a growth spurt. Getting it out whilst it's the size it is now is probably not a bad option. It's unlikely to ever be smaller or more innocuous than it is now.

    Feeling low in energy could be caused by lots of different things - especially if your TFT keeps coming back so-called normal. Half a thyroid versus a whole thyroid might not make much difference. 

    I always suggest it's better to deal what you might or might not have than to be paralysed by fear of a side effect that might not even happen.

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • FormerMember
    FormerMember in reply to barbaral

    Thank you for sharing, Barbara, you've helped me put things in perspective. I appreciate your responses, I've had no one else to talk to about this so it's nice to hear from someone who's been there.

  • FormerMember
    FormerMember

    I had a swelling on one side of my neck 1st discovered in may 2019 at my ENT appointment for tinnitus. I had bloods done immediately & FNA and scans within a few weeks then attended regularly for check up. My lump increased in size and in September 2020 i had another FNA which was inconclusive. I had initial surgery in Oct 2020 to remove half of my thyroid. The lump was in fact papillary cancer which then resulted  in thyroid completion surgery in January 2021. The cancer was contained to one side of my thyroid and I recovered well. I now take levothyroxine and so far I have no needed further treatments. I wish I had just had the whole thyroid removed during the 1st surgery. If you have the option to do this I would strongly advise you to.

  • Hi! I’m so glad you are well and needed no further treatment. I have had a total thyroidectomy and lymph gland removal nearly a week ago! So glad it is over. Now have Covid which isn’t great but at least my op is done! I asked if I would need RAI treatment and yes I do. Will get through this  but so want to get back to normal. Xx