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Results of Ultrasound

wmott1122
Posts: 14
Joined: Jun 2002

Hello again,
I saw the ENT today and he told me not to worry, that the ultrasound showed "just a cyst". He said it is septated, meaning "it just has some divisions" in it. I told him how paranoid I am since our family has been inundated with various cancers over the last 6 years. He said that cysts were nothing to worry about....it's the solid ones that are of concern. I told him that I had been doing research on the computer, and right away I could see he wasn't pleased. He told me sometimes the internet can be good, but sometimes he "hates it", because it can be misleading. I told him how I had read that ultrasounds can not be conclusive as to whether a cyst, nodule, etc is malignant or benign, so should I have a FNA. Of course he told me NO! I told him that he watched my husband's oral tumor for 6 months and even bet us his paycheck that it was benign, but it turned out to be cancer (We have yet to see his paycheck!!!!!), and that I was not willing to just watch my "cyst"! He then said he would order another TSH level (mine is 4.5 on a scale of .5 - 4.8) and he'd order a T4 level. He also said he would have me do a Thyroid Uptake, but I can not get in for that for another 3 weeks! He did not tell me the size of the "cyst", but he did have a hard time finding it when he examined me, so I'm assuming it is small. Has anyone here had a thyroid uptake test and if so, did it prove anything? Should I continue to pursue and persist, or is the doc right in that there's no need to worry for a septated cyst? I know I have been very fatigued, gained a lot of weight, have brain fog at times, difficulty swallowing, etc (some signs of Hypothyroidism), plus a lot of paranoia and anxiety about cancer! He also suggested giving me some kind of medication to lower my TSH and cause the thyroid to produce more hormone, which in turn should shrink the cyst....if it is "just a cyst", but he changed his mind and said he would have me try the medication after the thyroid uptake test. I'm trying to believe the doctor, but am very skeptical! Any help anyone can offer would be greatly appreciated!
Thanks!

Rustifox's picture
Rustifox
Posts: 131
Joined: Mar 2005

This website has a pretty good overview of the tests that endcrinologists will often utilize when dealing with our thyroid issues:
http://www.endocrineweb.com/tests.html

Only about 10% of nodules found in the thyroid gland will be found to contain cancerous elements. Because of this statistic, Doctors (rightfully so) most often believe any neoplasms found will be benign - and odds say that they are right... my surgeon was also certain of the same thing, so only removed half of the thyroid. It was only when the final pathology came back that we found it definitely was cancerous - and resulted in going back for a second surgery to do a completion thyroidectomy.

But - with that said, your doctor is likely to be right - but it is better to at least see what happens in the thyroid uptake scan. This site also agrees that cystic is likely benign, but it is best for your peace of mind to make certain:
http://www.endocrineweb.com/noduleus.html

With thyroid cancer, most of us have no symptoms, and our TSH levels are very normal. Yours are not, really - some endocrinologists now believe that the appropriate range for TSH should be revised to .50 - 3.50 - this would place you in the 'high' TSH range, indicative of slight hypothyroidism... but it can certainly be responsible for the symtpoms, and a lower TSH (attained by taking thyroid hormones) may also work to bring the size of that cyst/nodule down.

Personally, I would go through with the testing arranged - but don't worry too much. Even mild/subclinical hypothyroidism can have symptoms like those you've mentioned - there can be many reasons cystic types of nodules can appear, and do keep in mind that it is most likely it will be found to be a benign process. This pamphlet may also be helpful:
http://www.thyroid.org/patients/brochures/Nodules_brochure.pdf
And this website, too:
http://www.mythyroid.com/thyroidnodules.html
http://www.mythyroid.com/thyroidcysts.html

Hope these help a bit. I wouldnt' worry too much, but I'd go through with the test, to set your mind at ease. Your doctor has done the right thing to wait until after the test to put you on thyroid hormones, too. If he gave them to you now, it would alter the results of the thyroid scan - so waiting until you know more is best... Hopefully, it is exactly as your doctor has suggested - the odds are certainly more favourable when it is cystic.

alliesnene's picture
alliesnene
Posts: 23
Joined: May 2005

Just another opinion, since we all have different experiences. My papillary carcinoma presented with a cystic hygroma, a fluid filled cyst. Atypical presentation for this cancer. (I was already undergoing treatment for Grave's Disease.) An ENT performed the surgery. An FNA is conclusive, and would have eliminated the need for another surgery.....
Good Luck to you!!
Jen

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