Not sure if I should get 2nd opinion

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RE: Not sure if I should get 2nd opinion

by Lovemycats on Sun Feb 10, 2019 02:34 AM

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Thank you NickT for your reply.  A second opinion could give me piece of mind.  Thank you.

RE: Not sure if I should get 2nd opinion

by Lovemycats on Wed Feb 13, 2019 01:19 AM

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Thank you for your advice.  I'm in the process of finding another primary doctor.  I also thought losing weight is the opposite of what happens with menopause.  Thanks again.

RE: Ultrasound changes

by Lovemycats on Sat Aug 10, 2019 06:08 AM

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On Feb 03, 2019 4:49 AM Lovemycats wrote:

Hello.  I had an ultrasound done and right lower thyroid nodule measured 1.5cm x 1.0cm d 0.9cm.  Very hypoechoic, wider than taller, lobulated margins and no echogenic foci.  Ti-rads category 5.  FNA said benign follicular lesion.  My cousin has had thyroid cancer 2x. Don't know what type.  My endocrinologist said to have another ultrasound in a year then if nothing changes, should not have to worry about it.  I also have lost over 60lbs in last 2 years unintentionally and have taken Synthroid over 20 years. Endocrinologist said I might be loosing weight because of menopause.  After doing some research I now question the FNA results.  I Have Found information that said results of follicular cells  found in a FNA can be hard to distinguish between cancer and non-cancer cells.  Should I go for a second opinion or see what happens at the follow up?  Anyone else with similar experience?  The Ti-rads score of 5 scared me but I guess it did not mean much.  Any advice or sharing of experience would be helpful and appreciated.  Thank you.

My post above gives my original ultrasound and TH A results and recently had follow up ultrasound.  The results were 

Nodule size: 0.8 x 0.9 x 1.1 cm

Prior size :    1.0 x .09 x 1.5 cm

Composition : mixed

Ecogenicity : mixed

Shape : taller than wide

Margin : smooth

Echogenic : none

My question is should I be concerned with the changes, especially the taller than wide?  I know the other changes are on the positive side but that one is opposite.  Thank you for any input.  

RE: Ultrasound changes

by ToddlerFather on Sat Aug 10, 2019 03:45 PM

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The changes are within the error margin, so I would say your testes are stable. The two dimensions are too close to say whether is taller than wide or wider than tall. 

RE: Ultrasound changes

by Lovemycats on Sun Aug 11, 2019 04:24 AM

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Thank you for your input.  I appreciate your time.  Makes since when you put it that way.  Thanks again.

RE: Ultrasound changes

by butterfly501 on Mon Aug 12, 2019 11:09 AM

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On Aug 10, 2019 6:08 AM Lovemycats wrote:

On Feb 03, 2019 4:49 AM Lovemycats wrote:

Hello.  I had an ultrasound done and right lower thyroid nodule measured 1.5cm x 1.0cm d 0.9cm.  Very hypoechoic, wider than taller, lobulated margins and no echogenic foci.  Ti-rads category 5.  FNA said benign follicular lesion.  My cousin has had thyroid cancer 2x. Don't know what type.  My endocrinologist said to have another ultrasound in a year then if nothing changes, should not have to worry about it.  I also have lost over 60lbs in last 2 years unintentionally and have taken Synthroid over 20 years. Endocrinologist said I might be loosing weight because of menopause.  After doing some research I now question the FNA results.  I Have Found information that said results of follicular cells  found in a FNA can be hard to distinguish between cancer and non-cancer cells.  Should I go for a second opinion or see what happens at the follow up?  Anyone else with similar experience?  The Ti-rads score of 5 scared me but I guess it did not mean much.  Any advice or sharing of experience would be helpful and appreciated.  Thank you.

My post above gives my original ultrasound and TH A results and recently had follow up ultrasound.  The results were 

Nodule size: 0.8 x 0.9 x 1.1 cm

Prior size :    1.0 x .09 x 1.5 cm

Composition : mixed

Ecogenicity : mixed

Shape : taller than wide

Margin : smooth

Echogenic : none

My question is should I be concerned with the changes, especially the taller than wide?  I know the other changes are on the positive side but that one is opposite.  Thank you for any input.  

"Ti-rads category 5"

what did the second opinion conclude?  you still haven't even had a lobe removed? 

Follicular thyroid cancer is notorious for being difficult to diagnose, even with genomic testing. The TIRADS 5 is beyond concerning.

You should be concerned.

TI-RADS 5 category
  • malignant pattern B: isoechoic or hypoechoic, nonencapsulated, hypervascularized, multiple peripheral microcalcifications
  • malignancy pattern C: mixed echogenicity or isoechoic without hyperechoic spots, nonencapsulated, hypervascularized
TI-RADS 5: probably malignant nodules (>80% malignancy)

RE: Ultrasound changes

by kak123 on Mon Aug 12, 2019 06:38 PM

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several years ago my thyroid showed up on an MRI for a completely different reason for the exam. I was referred to ENT. He did 18 fna all with different findings. It was recommended that it be removed. Doc felt that the BX were so abnormal but not cancerous. He removed the thyroid and stated it was the largest one he had seen. So the worry of cancer is gone and taking one pill a day is easy. Good luck

RE: Ultrasound changes

by Lovemycats on Tue Aug 13, 2019 02:20 AM

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Hello butterfly501.  I did not go for a second opinion.  Thought I would wait and see.   I got the second ultrasound and do not think the nodule is still Ti-rads category 5.  It did not give a Ti-rads score on the report like my first one did and some things did change but this report was not as informative as the first. I was questioning it I should be concerned that the report says that the nodule is taller than wide.  The first ultrasound said wider than tall.  I received a reply from someone else and they said because of the size and margin of error it was not a real concern.   Thank you for taking the time to write me back.  

RE: Ultrasound changes

by Lovemycats on Tue Aug 13, 2019 02:28 AM

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Thank you kak123 for your information.  Glad to hear everything turned out well for you.  18 FNA is alot.  Not the most pleasant experiencen and all with different findings. That is scary to know that they might miss the spot where the cancer cells could possibly be.  Good luck to you and thanks again.

RE: Ultrasound changes

by butterfly501 on Tue Aug 13, 2019 03:13 AM

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On Aug 13, 2019 2:20 AM Lovemycats wrote:

Hello butterfly501.  I did not go for a second opinion.  Thought I would wait and see.   I got the second ultrasound and do not think the nodule is still Ti-rads category 5.  It did not give a Ti-rads score on the report like my first one did and some things did change but this report was not as informative as the first. I was questioning it I should be concerned that the report says that the nodule is taller than wide.  The first ultrasound said wider than tall.  I received a reply from someone else and they said because of the size and margin of error it was not a real concern.   Thank you for taking the time to write me back.  

Well, I wouldn't take that reply as any type of medical advice.  What you've provided is a tiny portion of what should be included in an imaging report. 

Folliclular lesions often times are not discernible by FNA. and difficult to discern be genomic testing.  That alone would prompt me to get a second opinion, but your YMMV.

Good luck!

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