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Can Cyberknife Surgery Remove A Benign Thyroid Nodule?
Question: Hi, Can cyberknife surgery be used to remove a large benign thyroid nodule? I am also curious about THS suppression therapy; It has been recommended that I remove the nodule because of the size (5.5 cm diameter), and I am hoping to avoid a hemithyroidectomy.
Hi,
Thanks for the query.
Cyberknife surgery is a recent innovation in delivering method of radiotherapy, with the intention of targeting treatment more accurately than standard radiotherapy.
It consists of a frameless robotic radiosurgery system used for treating malignant tumors ( WWW.WWWW.WW .
Since you have a solitary nodule which is usually a benign lesion it not an indication for Cyberknife surgery.
Secondly, you need to get a Fine Needle Aspiration Cytology (FNAC) done to know the type of lesion and to differentiate the benign nodules from cancerous solitary thyroid nodules.
Since you are having this nodule for a long time without any toxic features, it could be presumed as a benign lesion.
Hence the best treatment for your problem is surgery followed by biopsy of the specimen, rather than a thyroid hormone suppression therapy.
The surgery will be advised only if you are having a euthyroid state (i.e. normal thyroid function tests).
Hope I have answered your query.
I will be available for follow-up queries.
Regards,
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon.
Thanks for the query.
Cyberknife surgery is a recent innovation in delivering method of radiotherapy, with the intention of targeting treatment more accurately than standard radiotherapy.
It consists of a frameless robotic radiosurgery system used for treating malignant tumors ( WWW.WWWW.WW .
Since you have a solitary nodule which is usually a benign lesion it not an indication for Cyberknife surgery.
Secondly, you need to get a Fine Needle Aspiration Cytology (FNAC) done to know the type of lesion and to differentiate the benign nodules from cancerous solitary thyroid nodules.
Since you are having this nodule for a long time without any toxic features, it could be presumed as a benign lesion.
Hence the best treatment for your problem is surgery followed by biopsy of the specimen, rather than a thyroid hormone suppression therapy.
The surgery will be advised only if you are having a euthyroid state (i.e. normal thyroid function tests).
Hope I have answered your query.
I will be available for follow-up queries.
Regards,
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon.
Above answer was peer-reviewed by :
Dr. Manju M
Thank you, Doctor.
I have had a fine needle aspiration biopsy, which has shown the nodule to be benign. My thyroid function tests show normal thyroid functioning.
The nodule is not causing me any discomfort, nor is it a cosmetic concern for me. Still, I have been told it should be removed because of the size, and that half the thyroid must be removed along with it. In your opinion, is it problematic to keep it in? I am also wondering what the odds are in your experience that a hemithyroidectomy would result in hypothyroidism.
Thanks again.
I have had a fine needle aspiration biopsy, which has shown the nodule to be benign. My thyroid function tests show normal thyroid functioning.
The nodule is not causing me any discomfort, nor is it a cosmetic concern for me. Still, I have been told it should be removed because of the size, and that half the thyroid must be removed along with it. In your opinion, is it problematic to keep it in? I am also wondering what the odds are in your experience that a hemithyroidectomy would result in hypothyroidism.
Thanks again.
Hi,
Thanks for writing back to me.
1. Is it problematic to keep it in?
Yes, a long standing solitary nodule can pose problems later on, the centre of the nodule can undergo cystic degeneration because of constant pressure, sudden bleeding might occur in those cystic changes and rarely can it become malignant. So I do not mean to say that it can happen with everyone, but these are the probabilities. And, a lesion of 5.5cm, is indeed a matter of concern.
2. What the odds are in your experience that a hemithyroidectomy would result in hypothyroidism?
Not all operated cases will experience hypothyroidism, around 25% - 30% of the patients become hypothyroid with or without hypocalcemia but it is transient, and they would require mild doses of Levothyroxine for few months till the gland is able to function normally.
Hope I have answered your queries.
Wish you good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Thanks for writing back to me.
1. Is it problematic to keep it in?
Yes, a long standing solitary nodule can pose problems later on, the centre of the nodule can undergo cystic degeneration because of constant pressure, sudden bleeding might occur in those cystic changes and rarely can it become malignant. So I do not mean to say that it can happen with everyone, but these are the probabilities. And, a lesion of 5.5cm, is indeed a matter of concern.
2. What the odds are in your experience that a hemithyroidectomy would result in hypothyroidism?
Not all operated cases will experience hypothyroidism, around 25% - 30% of the patients become hypothyroid with or without hypocalcemia but it is transient, and they would require mild doses of Levothyroxine for few months till the gland is able to function normally.
Hope I have answered your queries.
Wish you good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2540 Questions
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