Total Thyroidectomy or Lobectomy?



I'm new to this network - joined recently after I received my biopsy results.  Apparently, I have MNG, with the primary nodule being approximately 5 cm (which is very large, I'm told).  The results of my FNA showed atypical, with Hurthle cell changes suspected and vascularity noted within the rim.  I have another nodule on my isthmus, which is 11mm and three other tiny ones.  Here's where I'm struggling:  on my left lobe, I have the large nodule and 2 other small nodules.  On my right, I have only one 2mm nodule.  My doctor is recommending a total thyroidectomy, but I'm not sure..?  If he takes out the isthmus and the left side, I will still have a right lobe with a tiny nodule (which may not even be cancer) and may be able to avoid synthroid (I'm told that there is an 80% chance).  I'm only 43 and not sure that I want to be on meds for the rest of my life if it can be avoided.  I understand that if they find cancer in the left lobe or isthmus, that they'll have to go back and take the rest of my thyroid out - this seems like a good plan to me (to keep half if it's healthy).  Am I being silly?  How can I decide what to do?  Any advice is appreciated. 

Mahalo nui loa,



  • tbjgreen390
    tbjgreen390 Member Posts: 1
    edited August 2017 #2
    thryoidectomy vs lobectomy

    I am having the same issue.  I hope someone chimes in with any insight.


  • smith221519
    smith221519 Member Posts: 3

    thryoidectomy vs lobectomy

    I am having the same issue.  I hope someone chimes in with any insight.


    pros and cons

    I had a lobectomy in July at the recommendation of both my surgeon and endocrinologist (and the doctors I got second opinions from), but to everyone's surprise, my nodule came back as a Hurthle Cell Carcinoma. Current medical standards apparently recommend a "wait and see" approach to see if anything appears in the second half before taking out the rest of the thyroid.  I have young kids though and want to minimize the chance that metastaces show up later, so, after reading many accounts of people whose Hurthle cells kept reappearing and weighing the knowns and unknows about Hurthle Cell Carcinoma, I decided to take the rest out. I had a second surgery 8 days after the first (my option was basically to do it right away or wait 6-12 months or more, after everything healed up from the first procedure). The first surgery was easier to recover from. The second was rough for a couple of days, and recovery has been slower overall (4 weeks out, I don't think I am back to where I was a week after the first surgery). So I guess the thing to think about is, if yours is malignant- what would you prefer longer term? Being on thyroid meds forever (and the challenges that go with getting meds right) or having frequent monitoring tests and wondering "what if" should your cancer come back later in the other half of your thyroid (particuarly if you have a more agressive type of thyroid cancer)? My surgeon basically told me that, despite medical standards to only remove half, it's basically a question of, do you need the peace of mind of knowing you took the more agressive approach or are you ok with waiting to see what happens.

  • genebing_md
    genebing_md Member Posts: 8

    hi everyone!

    i too initially had nodular goiter by ultrasound and by repeated fine needle biopsies. i was all set to have a partial left lobectomy until those few seconds before they put me under anesthesia - when me and my surgeon decided that it was best just to have total thyroidectomy. Here's why:

    Theoretically, removing one lobe will signal the brain to stimulate thyroid hormone production to compensate - this will eventually lead to the lobe that is left to enlarge itself. 

    Biopsies are not the whole mass- they are just a tiny part of it. Unfortunately for me, the mass they removed eventually turned out to be papillary cancer. Luckily, I do not have to go in for another surgery.

    Hope this helps

  • AA1972
    AA1972 Member Posts: 6
    Thyroid nodule FNA Report risk of Follicular neoplasm

    Hi everyone, I am new here. I hope and pray all your hardships be eased. I am 44 year old female with good health maybe. In regular check up my dr. found this thyroid nodule, had ultrasound and FNA done in april 2013.  My thyroi U/S shows right lobe enlarged and hypoechoic, well circumscribed nodule. After days and weeks of research, I am very confused still on my FNA report. Dr said to follow up yearly, I have not been there since. I am hopeful this is just a regular FNA Dx but I want some feedback from the real people who have first hand knowledge of matter at hand. Dx says that "Findings are consistent with Follicular lesions with low to moderate risk for Follicular neoplasm" . I don't know if this falls in suspicious category or indeterminate??? Due to limited finances and no insurance, I am tooo careful to even visiit a doctor. Please guide that if I need to go and get checked again now or it can wait if not an issue. But if you guys suggest going and seeping a professional then would a endocrinologist or oncologist be best so he can finally clear the confusion and I can get off the edge. I am anxious to get some kind replies. Thank you in advance Y'all for your kindness and time. PEACE.