23yo Papillary thyroid carcinoma pt. right lobe removed, now 2mm nodule in left lobe
Looking for advice... called my doctor to set up an apt but they haven't gotten back to me yet. a few months ago I noticed an enlargement of my level IIa lymph node on the right side of my neck so i went to my general practitioner and he had me go in for an MRI... the lymph node came back normal however they did find a 1.5mm nodule on my thyroid. flash forward to Nov 2nd, fna was done which came back highly susceptible for class IV follicular neoplasm.
Ultrasound revealed 1.5mm semi-solid cystic nodule on my right lobe, left lobe was clear of any nodules. I opted to have my right lobe taken out due to the suspicion. The pathology came back that it was a 10mm well-circumscribed non encapsulated variant of papillary thyroid carcinoma. My endocrinologist started me on 50uG levothyroxine and the plan was to go in every 6 months for an US of the left thyroid. as long as the left thyroid was under producing and my tsh / t4 levels were fine and there were no nodules I would just go on with my life. My endo also had me go in for an US + Chest CT for good measure just to make sure it hasn't spread anywhere.
The chest ct came back normal, however the US came back w/ a 2mm nodule. I'm confused now as the doctor has told me that since I was already diagnosed w/ thyroid cancer, that if any new nodules are reported on my left lobe we should treat it as if its cancer and just remove the lobe and do the I-RAI treatment for safe measure... however the US report suggests waiting 6 months for another US for observation only... Plus it mentions nothing about what to do for my enlarged lymph node that brought us into this situation in the first place. Attached below is my US report... Looking for suggestions on what you think I should do... Currently scheduling an apt. with my endo plus looking for another endo for a second opinion.
HISTORY: Hemithyroidectomy for thyroid cancer.
TECHNIQUE: Soft tissue ultrasound of the neck is performed.
FINDINGS: The patient is status post right thyroidectomy. The
right thyroid bed demonstrates no obvious masses.
The left lobe measures 3.5 x 1.1 x 1.0 cm in size and has a 2 mm mid
pole hypoechoic heterogeneous nodule. The isthmus contains two
complex heterogeneously hypoechoic, partially cystic nodules. They
measure 0.8 x 0.4 x 0.6 cm and 1.0 x 0.3 x 0.6 cm. May alternatively
be postsurgical changes.
RIGHT NECK: A right level 2a node measures 1.2 x 0.6 x 0.9 cm in
size with a hypoechoic periphery, echogenic hilus and central
vascularity. A right level 3 node is 1.6 x 0.3 x 0.8 cm, elongated
and hypoechoic with an echogenic hilus and central vascularity.
A right supraclavicular node is 1.0 x 0.5 x 0.9 cm with a hypoechoic
periphery, an echogenic hilus and central vascularity.
LEFT NECK: A left level 2a node is 1.4 x 0.8 x 1.7 cm with
hypoechoic periphery, an echogenic hilus and central vascularity. An
additional 1.7 x 0.7 x 1.0 cm level 2a node also demonstrates a
hypoechoic periphery and an echogenic hilus but lacks central
A left level 3 node is 1.7 x 0.4 x 0.8 cm, elongated and hypoechoic
with an echogenic hilus and central vascularity. A left level
3/supraclavicular node is 0.8 x 1.2 x 0.6 cm with a hypoechoic
periphery, echogenic hilus and central vascularity. A left level 3
node seen laterally is 2.1 x 0.5 x 1.5 cm with a hypoechoic
periphery, echogenic hilus and central vascularity.
Bilateral cervical nodes as described. Only a single left level 2a
node lacks central vascularity. Continued followup recommended in 6