Question about Father's High TSH and Large Nodule

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Hello,

Thank you for reading my message about my father.

Father is 87, lives in India. Primary care Physician did a routine physical and found a very high TSH of 9.82 (0.34 - 4.25) and normal values of T3 and T4. TSH was previously measured in July 2021, and it was 4.5 and since it was borderline, no further testing was done. Un ornately the thyroid testing was not done in physicals until now.

A neck ultrasound found a 6 cm x 3.4 isthmus nodule with a calcified focus. Cystic nodules in both lobes. Right lobe was atrophic and showed coarse echotexture: Chronic thyroiditis. Benign Nodule with a TIRADS 1/2. The submandibular glands are normal. No obvious lymphadenopathy.

Was referred to a cancer surgeon as the nodule is very large. He tested for Thyroglobulin. It came out as 21.2 (1.7 - 55.6). He advised against biopsy for now. Prescribed daily 50 mcg of Thyroxin. Asked to see him in two months.

Questions:

1) If father's nodule is cancerous, will waiting two more months make it spread beyond the thyroid? Better to do the biopsy now?

2) Is it better to see an Endocrinologist at this point and do additional tests like thyroid antibodies, Free T3 and T4 etc. to look for signs of cancer?

Thank you,

Zent

  • Hi Zent, sorry to hear about your father's situation, that must be very stressful for you both. Your information and questions are quite detailed and I'm wondering if they'd possibly get a more comprehensive and professional reply if they were posted on the Ask A Nurse forum? Just my thoughts. There may well be members on here who could answer them for you and I hope they'll reply shortly for you. Do you have the number/email of a clinical nurse specialist working in the cancer surgeon's team whom you could ask? Mine was very quick to reply and to help me with any questions I had.

    Medullary Thyroid cancer dx May 2023

  • Hello,

    Thank you for your reply. I have been able to speak with the surgeon, but I wanted to hear from forum members as well. 

    Take care