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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have papillary carcinoma of the thyroid. Feeling tired. Surgery needed?

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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1465 Questions

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Posted on Thu, 10 Jan 2013 in Thyroid Problem and Hormonal Problems
Question: Have a week before I get to talk to dr. I'm just trying to figure how this report will effect my business will he recommend treatment ASAP or is this a slow growing cancer? Do you think surgery will be first option thinking of my clients and if I'll have to reschedule them. For the most part I don't feel sick mostly tired. The report reads
Right thyroid nodule fine needle aspiration cytology. Papillary carcinoma of the thyroid with oncocytic/hurtlhle cell features. General categorization. Positive for malignacy
8*8*7 hypoechoic nodule mid portion of right lobe specimen right lobe

Cytology preparation appears highly cellular and contains groups and sheets of large epithelial cells demonstrating marked nuclear pleomorphism, high n/c ratios and frequent optically clear nuclei. Focal papillary architecture is present. Several nuclear inclusions and frequent nuclear grooves are seen. An occasional mitotic figue is noted.
The majority of of large cells contain finely granular eosinophilia consistent with oncocytic/hurtlhle cell change. Colloid is not identified.

I understand the nodule to be quite small even though it has grown

My symptoms other being tired but not sleeping and messed up swallowing sometimes wouldn't be thyroid related I get winded a little easier now and my left side rib cage area feels uncomfortable .....
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Answered by Dr. Indranil Ghosh 3 hours later
Hi
Thanks for writing in.

I have gone through your history. It appears that you have developed a papillary thyroid cancer on a background of long-standing thyroid problem. I don't think your other symptoms like tiredness are related to this.

Fortunately the size is small and the standard treatment is surgery. After surgery, depending on the histopathological features you may or may not require radioiodine therapy. That should be it. The long-term prognosis is excellent.


Hope I have answered your query. I will be happy to answer any follow-up queries.
Best Wishes,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indranil Ghosh 12 minutes later
Not long term thyroid disease. Found nodule about a year ago but month ago on physical TSH was elevated then had the US that shown it had grown. Anyway great prognosis do you think the surgery will be scheduled verily quickly or no rush because it is slow growing and how long out of work
doctor
Answered by Dr. Indranil Ghosh 2 hours later
Hi
Thanks for the clarification.
Anyway that does not change the approach. Hopefully you will be able to resume your work by 2-3 weeks.
Even though it is small, I would recommend surgery as early as possible.

Best

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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