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Dr. Andrew Rynne

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What treatment should be done for papillary thyroid cancer with huthles cancer cells?

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Dr. Madhuri Patil

Diabetologist

Practicing since :1999

Answered : 362 Questions

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Posted on Tue, 29 Jan 2013 in Thyroid Problem and Hormonal Problems
Question: Hi I am a 61 yr female and over all in pretty good health. Recently got a diagnosis of papillary thyroid cancer with Huthles cell cancer cells. Lucky for me the nodule is small but had grown since original US a year ago. My doctor didn't feel I deeded the US but for some reason I insisted on one. That came back as "significant suspicion for neoplasm XXXXXXX and recomended FNB. Again my Dr didn't think that was necessary but after I got the copy of US I insisted on biopsy. Surgery scheduled at end of month. My question is what symptoms and how long before I would have know I had a cancer brewing? If margins are ill defined and there was some vascular in the thyroid does that mean it is no longer encapsulated
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Answered by Dr. Madhuri Patil 2 hours later
Hi there.

thank you for the query. I must appreciate your perseverance in getting your thyroid nodule diagnosed correctly.
For this kind of thyroid cancer (pap-Ca), generally there will not be any symptoms till it reaches some serious stage where the tumor grows into surrounding tissues and affects your voice, increases in size visibly (not only by US), makes it difficult to swallow food/ saliva, some visible lymph nodes are seen in your neck, losing significant weight etc.
Yours seems to be certainly confined to your thyroid and not yet gone into surrounding tissues though margins are ill-defined (margins of the nodule are ill-defined, not that of thyroid gland).
Even though I cannot comment on precise time period of your cancerous nodule, it is certainly not there for more than 1 year. I have explained above the symptoms for progressed cases and not for early stage or thyroid-confined cancer.
If margins are ill-defined and vascularity has been changed (increased) then yes, it might not have its capsule.
But should you worry about this. No. The reason being even though the nodule is capsulated the whole of the thyroid is taken out of your body the way they are going to do for you during your planned surgery. Also the surgeon will look for any affected lymph nodes and will chop them off. After the surgery they will comfirm the report of cancer by histopath lab and also will ask you for some repeatative tests to confirm that there is no spread or re-growth of the cancer in your body.
Please remain courageous the way you have been. All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Madhuri Patil 54 minutes later
What determines after reading the US whether you have an iodine scan as the next step or a FNB. Some people I know had iodine imaging and I had the FNB. Is one more accurate at determining the type and extent of cancer
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Answered by Dr. Madhuri Patil 20 minutes later
Type of cancer is determined by FNB and extent of cancer is determined by the iodine scan.
In your case, if they have seen that thyroid gland as such has not lost its shape and margins as observed in the US then only FNB is good enough from the nodule area which might have lost its margins and might have had increased or changed vascularity compared to the background thyroid tissue.
They must have checked other surrounding tissues in the neck and found out that no spread is suspected. Otherwise those things (like spread into surrounding tissues)are clearly mentioned in your US report.
And hence this might be the reason that an iodine scan was not asked for.
I hope you are relaxed after getting to know this answer. Please get back for any related query. take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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