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What Does My Thyroidectomy Report Indicate?

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Posted on Mon, 3 Jul 2017
Question:
I had a recent thyroidectomy and was told no lymph nodes were sampled. The pathology came back from the surgery and looks like there was a lymph node removed and is positive for cancer. My question is: if one lymph node is involved and found to be metastatic, how many more are typical? Would a pet scan or thyroid uptake scan be next? Ive been referred to oncology but wondering what is typical. Thank you.
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Answered by Dr. Prof. Kunal Saha (3 hours later)
Brief Answer:
All the surrounding lymph nodes are usually excised.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. The first stage of any cancer is when it is limited to the organ and has spread no further. From there it can either spread locally or may spread through the lymphatics into the lymph nodes. This is not metastasis. Metastasis is the distant spread to other organs through the route of blood. In your case the margins are cancer free. So you can rest assured that there is no local spread. The spread to the lymph nodes has occurred but excision of the lymph nodes should be enough to eliminate the cancer. That a lymph node has been sent for biopsy does not mean that only one lymph node has been excised. The doctor would have removed whatever he felt justified based on his degree of suspicion. You would need to talk to him about how extensively he has excised. It is typical for a surgeon to remove all the nearby lymph nodes.

The next step would indeed be to go for the oncology referral. Whether you need to go for a PET scan or thyroid updake would depend on the judgment of the oncologist. I doubt if those would be required.

Let me know if I could help further.

Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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What Does My Thyroidectomy Report Indicate?

Brief Answer: All the surrounding lymph nodes are usually excised. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through your query and understand your concerns. The first stage of any cancer is when it is limited to the organ and has spread no further. From there it can either spread locally or may spread through the lymphatics into the lymph nodes. This is not metastasis. Metastasis is the distant spread to other organs through the route of blood. In your case the margins are cancer free. So you can rest assured that there is no local spread. The spread to the lymph nodes has occurred but excision of the lymph nodes should be enough to eliminate the cancer. That a lymph node has been sent for biopsy does not mean that only one lymph node has been excised. The doctor would have removed whatever he felt justified based on his degree of suspicion. You would need to talk to him about how extensively he has excised. It is typical for a surgeon to remove all the nearby lymph nodes. The next step would indeed be to go for the oncology referral. Whether you need to go for a PET scan or thyroid updake would depend on the judgment of the oncologist. I doubt if those would be required. Let me know if I could help further. Regards