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Having headache and neck pain. Esophagram result came normal and thyroid ultrasound showed isoechoic nodule. Meaning?

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ENT Specialist
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My Sinus and ear fluid problem has gone, along with headaches too. But I am still having frequent aches around neck from time to time, at times feels like pinching. Looking at my history my doctor order two tests Thyroid ultrasound and ESOPHAGRAM.

Results from Esophagram: Barium and granules were administered orally without difficulty. Esophagus is normal in mucosal pattern and motility. No hiatal hernia is evident, no gastroesophageal reflux was visualized during the study which doesn't exclude that diagnosis. The opacified portions of the stomach and proximal small bowel are considered with in normal limits. Rapid sequence imaging of the cervical esophagus appears normal as well.

Results from Thyroid ultrasound: The thyroid gland is homogeneous throughout. The right thyroid lobe measures 4.8*1.7*1.1 cm. The left thyroid lobe measures 5.1*1.7*1. cm. The isthmus measures 3.5 mm. Normal echogenicity and blood flow. Posterior to the mid aspect of the left thyroid lobe there is a 7*5*6 mm isoechoic nodule. This could represent a parathyroid nodule

What does this report means and what should be my next steps? If any treatment is required and prognosis?
Posted Sun, 17 Nov 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Hariom Sharma 5 hours later
Brief Answer:
Left parathyroid adenoma

Detailed Answer:
Hi Sir,

It suggests that you may be suffering from the left parathyroid adenoma. If you were my patient, I would order for the following test to arrive at a diagnosis and to plan my next treatment
1. Serum calcium level and vitamin D level.
2. 99m Tc sestamibi scan.
3. Parathyroid hormone level.

If the tests confirm that you have the parathyroid adenoma, then I would opt for surgical removal of this adenoma as early as possible. Surgery cures adenoma more than 95% cases i.e. prognosis is very good.

Discuss with your surgeon about this possibility.

Hope this helps. Let me know if you need clarifications.
Wish you good health.
Above answer was peer-reviewed by
 
Follow-up: Having headache and neck pain. Esophagram result came normal and thyroid ultrasound showed isoechoic nodule. Meaning? 13 hours later
Are isoechoic nodules cancerous..?
 
 
Answered by Dr. Hariom Sharma 22 minutes later
Brief Answer:
Benign Nodule

Detailed Answer:
Hi Sir,

Thanks for the followup.

Isoechogenesity suggests the benign nodule, not cancer.

Wish you good health
Above answer was peer-reviewed by
 
Follow-up: Having headache and neck pain. Esophagram result came normal and thyroid ultrasound showed isoechoic nodule. Meaning? 48 hours later
My PTH level came normal. I have heard about HPV, could it be "HPV"? Please advice the next steps, what could this be..?
 
 
Answered by Dr. Hariom Sharma 9 hours later
Brief Answer:
Not HPV

Detailed Answer:
HI Sir,
I have gone through your follow up query.
Normal PTH doesn’t rule out benign parathyroid nodule.

You need to go for above mentioned two tests.

Please go through these tests- after this I am able to give you good suggestion about this.

HPV is the Human papilloma Virus - mainly it have two strain first transmitted through the oral sex and second one with anal sex/ vaginal sex.

If you have any doubt, I will be available for your query.

Wish you good health.
Above answer was peer-reviewed by
 
Follow-up: Having headache and neck pain. Esophagram result came normal and thyroid ultrasound showed isoechoic nodule. Meaning? 4 hours later
Hi,

The email indicate the query has been answered but I can't see the answer..
 
 
Answered by Dr. Hariom Sharma 3 hours later
Brief Answer:
Just again check

Detailed Answer:
Hi Sir,
I have gone through your follow up query.

Just check your email again for this or contact with Health care magic (Customer care). I already have given the answer of your query.


Wish you good health
Above answer was peer-reviewed by
 
Follow-up: Having headache and neck pain. Esophagram result came normal and thyroid ultrasound showed isoechoic nodule. Meaning? 32 hours later
Hi,

The calcium test shows ionized calcium of 5.5 mg/dl (which my doctor think is normal)

My symptomps: Sensation on the neckline (around the shoulder), Confusion after eating, at times slurry speech - loss of words, weight loss, difficulty concentrating, stiffness around neck (which gets little better after I relives myself).

I think something big is going on, just don't know. I am meeting a GI after 2 days, any advice on that.


My doctor didn't order test for calcium serum, but I had the blood test done around a month back which indicated calcium serum as normal with the value of 10 mg/dl
 
 
Answered by Dr. Hariom Sharma 9 hours later
Brief Answer:
Normal Calcium Level

Detailed Answer:
Hi Sir,

Normal laboratory values (adult patients):
Calcium (Serum): 8.5 - 10.5 mg/dL (2.12 - 2.57 mmol/L)
Calcium (Ionized) Serum: 4.5 - 5.6 mg/dL (1.1-1.4 mmol/L)

You can also plan to visit a neurologist after gastro visit to discuss about the list of symptoms. I am sure you will be able to find helpful treatment after the neuro visit.

Hope this helps.

Wish you good health
Above answer was peer-reviewed by
 
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