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How is thyroid cancer treated ?

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Internal Medicine Specialist
Practicing since : 1998
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Hi,
I'm 45 years old, 5'2" 128 lbs. I don't smoke or drink. I have a history of thyroid cancer. I just had Moh's surgery for recurrent BCC on my chest. I have now found a XXXXXXX pink, almost red spot on my head that has scabbed over in the middle. It was biopsied and I'm waiting for results. How likely is this cancer and if so what kind? I am worried about amelanotic melanoma and SCC. If it is SCC would I have Moh's again even though this is a primary? (Also, two spots on my lung, one ground glass. I have had several scans and they haven't changed, but too small to biopsy right now) Thanks
Posted Sun, 15 Apr 2012 in Cancer
 
 
Answered by Dr. Jasvinder Singh 22 minutes later
Hello,

Thanks for posting your query.

I can understand your concern for these symptoms given your history of thyroid cancer and recurrent BCC (rash on scalp that has scabbed over can be due to :

1 ) Basal cell carcinoma. Since you already have a history of BCC and scalp is one of the commonest location after face and chest to be effected, so this possibility cannot be denied.

2)Actinic keratosis which appear as rough, red bumps on the scalp, face, ears etc and may invade deeper in the skin to become a fully-developed squamous cell carcinoma. Hence this lesion can be a squamous cell carcinoma. If biopsy confirms it as squamous cell carcinoma then it is generally treated by surgical excision or Mohs surgery.

3) Last possibility is of angiosarcoma which initially appears clinically innocent and may begin as ill-defined bruise like areas with an indurated border.

4)Appearance of ground glass spot in lung maybe due to :
Pneumocystis pneumonia (PCP)
• Viral pneumonias
• Acute interstitial pneumonia
Hypersensitivity pneumonitis
• Interstitial lung diseases (NSIP, DIP)
• Bronchoalveolar carcinoma

You will have to discuss this with your treating physician.

From these, diagnosis can only be confirmed after biopsy skin. Hence it is better to wait for the biopsy results and then decide the mode of treatment.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.








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Follow-up: How is thyroid cancer treated ? 31 minutes later
Thank you for your response. What is the possibility of an amelanotic melanoma?
 
 
Answered by Dr. Jasvinder Singh 16 minutes later
Hello,

Thanks for writing back.

The possibility of amelanotic melanoma is rare because it is one of the rare cancers that can occur on this site.

In women, common sites for a melanoma are the arms and legs and it is very rare for amelanotic melanoma to present on head.

An incisional biopsy technique is appropriate when the suspicion for melanoma is low, or when it is impractical to perform an excision.

However without examination and a biopsy result, it is very hard to say what type of growth this is.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
 
Follow-up: How is thyroid cancer treated ? 10 hours later
Thank you. Last questions. I appreciate the help. Hopefully I will find out this week. If it is squamous, do you suggest Moh's even though it is primary?
 
 
Answered by Dr. Jasvinder Singh 13 hours later
Hello,

Thanks for writing back. With the exception of cryotherapy, treatment options for SCC are similar to those for BCC. Moh's micrographic surgery is often used to treat high-risk tumors with poorly defined clinical borders and surgery is best suited to the management of tumors in cosmetically sensitive areas and scalp is one such area.


Radiation therapy is a logical treatment choice, particularly for patients with primary lesions requiring difficult or extensive surgery (e.g., nose, lip, or ears). Hence Moh's surgery may be preferred.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
 
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