Pt1b ccRCC in Nov 23 & (pre-existing) Thyroid nodule

Michael7

My father underwent a partial nephrectomy last November. The pathology report showed a pT1b Fuhrmangrade II tumor, measuring 4.2 cm. Right after surgery, another CT scan of the abdomen and thorax was done (also before surgery; everything clear with just a small 4 mm lung nodule), and the radiologist noted a 15 mm hypodense lesion in the thyroid but didn’t give much additional information. From what I’ve read, CT imaging doesn’t provide much insight into thyroid nodules and I'm getting more and more crazy as I go down every rabbit hole as a researcher myself.

Recently, my father asked our family doctor to take another look using ultrasound, and he found 1-2 hypoechoic nodules (likely cold nodules), which supposedly haven’t changed in size. He suggested I see an endocrinologist for further tests, such as a scintigraphy.

Now, after googling, of course, I came across all the worst-case scenarios, including the rare cases of RCCclear cell metastasis to the thyroid. From what I’ve seen, this happens after a significant delay, sometimes even 10 years post-surgery, and only a few hundred cases have been documented.

What concerns me is that studies highlight how difficult it is to diagnose these thyroid metastases in patients with a non-thyroid cancer history—especially RCC, which apparently makes up 50% of the rare thyroid metastasis cases. Even biopsies can be misleading.

Has anyone here experienced something similar or also have (cold) nodules ? I’ve seen cases online where doctors aren’t immediately worried and just keep monitoring the nodules. However, studies also emphasize that someone with a history of RCC should always be checked thoroughly for metastasis and I'm afraid of misdiagnosis. Even afraid that Pt1b is in doubt.

Example for a study:

https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-7-265

Allochka

Hello Michael,

I am sorry that you are going through so much anxiety. As far as I know, kidney cancer Stage 1b Fuhrman grade 2 has a great prognosis. Just read this forum! So many inspiring stories! And I’ve never heard of thyroid mets at all. However, some people here had a separate thyroid cancer in addition to their kidney cancer. And thyroid cancer is very treatable! Also, as my mom has thyroid issues, I know that thyroid nodules are extremely common.

But I’d also like need to admit that I can see myself in your story. I am a recovering hypochondriac (but it can’t go away fully, I am afraid). The frantic research, belief that the rarest medical case would definitely happen to you - it is a path to terrible anxiety, which would worsen quality of life much more than Stage 1 kidney cancer in your dad’s anamnesis. I did the same in the first years after my husband’s diagnosis - every spot on ultrasound, every little pain in him meant mets for me :-( I was able to find the rarest medical cases proving my suspicion, and went crazy. Like, mets to the kneecap, etc. Same as mets to thyroid - crazy rare, but we are sure it is the case for us… And I was never right, never!
You must be cautious about your dad’s health, of’course. Check these nodules out. And when it is proven they are benign - trust the doc and stop looking into every slight pain, etc. You’ ll drive yourself and your family crazy. Perhaps you could speak to a psychologist for some support?

I am afraid I’ve transferred some of my anxiety to my 9 year old daughter :-(. not health anxiety, as for me, but another type, but still. Please try to stop as soon as possible in order not to screw your and your family’s menthal health :-(

Your dad will be fine - both kidney cancer wise, both thyroid wise (whatever these nodules are, even if cancer - it is very treatable). Take care!

Hugs and I apologise if I sound too patronizing or insensitive - English is not my native language…

Alla