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Have goitre. Ultrasound showed thyroid glands have nodule enlarge. What can be done?

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Dear Dr. I have goiter, I do ultrasound , the result my thyroid gland have nodule enlarge 22,3mm , 17mm
What I need to do? I used to do surgeries 1 time already since 2005.

Thank you
Posted Wed, 22 May 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Om Lakhani 1 hour later

It seems you have Non Toxic multinodular goitre.

I would advice you to get done a USG guided FNAC or Biopsy of the nodule. If the nodule does not show any malignant change than surgery is not required. However if it is disfiguring, surgery may be done.

If FNAC or biopsy is showing something suspicious we may have to go for investigations to find out the extent of spread of the disease to nearby lymph nodes.

PS: Please send the English translation of your thyroid USG report as it is in some other language and difficult to interpret the report.

Dr. Om Lakhani.
Above answer was peer-reviewed by
Follow-up: Have goitre. Ultrasound showed thyroid glands have nodule enlarge. What can be done? 12 hours later
Dear Dr.

Thank you for your reply, the nodules on my neck, is big, it's can see from out side. I used to test blood on Jun-2012: T3 Libre=3,40 , T4 Libre=1.40, TSH 3rd Generation =0.178

and the new test blood is: T3 LIBRE=3.98 , T4 LIBRE=1.23
the Doctor in Cambodia said, no need to take any medicine because i have normal test. And just ask me to decide to do surgeries.

I had ask the laboratory in my country for to do Biopsy thyroid gland, they said, can't do it before surgeries, they test biopsy after surgery, I don't know what they process or they don't have modern technich. What can I do? I can't do ask your advice.
Answered by Dr. Om Lakhani 2 hours later
Hi Ratana

Let me answer your second questions. FNAC is a small needle inserted into you thyroid nodule and sent for examination. Biopsy would be surgical removal or the thyroid nodule and sent for examination. You can ask for FNAC of the thyroid gland before surgery, Biopsy is done with the surgery and examination of it is done in the pathology lab after the surgery.

Seeing your previous report of thyroid function it is a toxic nodula goitre which is now normalized after medications ? Can you tell me which medications you took. If it was a toxic nodular goitre (with hyperthyroidism) then risk of malignancy are less no I would not recommend preoperative FNAC.

The best treatment of a toxic nodular goitre is surgery and this is the right time to do it because right now you thyroid functions are normal. The surgery for thyroid would solve the problem once and for all.

I agree with you doctor in Cambodia that you dont require any thyroid medications as of now because your thyroid functions are normal. If you dont go for a surgery there is no other problem , however your thyroid gland may become hyperfunctioning again in future and you may require medications again, so better go for the surgery.

I hope that helps you in your decision Ratana.

Dr. Om Lakhani.
Above answer was peer-reviewed by
Follow-up: Have goitre. Ultrasound showed thyroid glands have nodule enlarge. What can be done? 46 minutes later
Dear Doctor

The medicine I took in Jun-2012 (30 days) is: PTU 50

The Doctor told me that, The surgeries will remove all my Thyroid gland (if I decide to do surgeries, and it's is the 2nd time for my thyroid surgeries, when the 1st surgeries in 2005). It is necessary to remove all thyroid gland? and what effect to me after remove thyroid gland, Can I have a baby after my surgeries?

And the last 2 months I had another prescription (CALCIVITA, ZIFAM, MONTIGET, NEOCILOR, LECIBIOL) for my other functions.

Thank you

Answered by Dr. Om Lakhani 57 minutes later
Hi Ratana

Yes they will remove all the thyroid tissue else the remaining thyroid tissue will grow again. After removing the thyroid gland they will replace you thyroid hormones with medications. As long as your thyroid function is normal after the thyroid hormone replacement there shouldn't be much of an issue with pregnancy.

You were taking PTU so that confirms that you had a hyperthyroidism previously.

Hope that helps

Dr. Om Lakhani.
Above answer was peer-reviewed by
Follow-up: Have goitre. Ultrasound showed thyroid glands have nodule enlarge. What can be done? 1 hour later
Dear Doctor,

So that mean, now it's the best for me to do surgery? and how long do I need the medicine to replacement? Do I become a abnormal person after remove thyroid gland? I'm very scare to decide to do surgery or not.

Answered by Dr. Om Lakhani 52 minutes later

If the thyroid gland is removed totally then you will need replacement for life. If you are afraid of surgery you can take your time. Right now your thyroid function are normal so there is no urgency of surgery
However that is the right option to consider.

Dr. Om Lakhani.
Above answer was peer-reviewed by
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