Q. Is thyroid cancer any way related to adenoma?

 

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Hello doctor,

Before 20 years I had total thyroidectomy for follicular and papillary thyroid cancer. I also had three surgeries to remove benign lymph nodes. My levels had been pretty steady until the last one and a half year. I am post menopausal. I am now with the highest TSH value of 13.1. I did not even miss any dose. I am eating very healthy and doing work out. My TSH works best for me at 2. Now I am on 112 mcg Synthyroid. My doubts are as follows. Is thyroid cancer any way related to adenoma? Is follicular nodular hyperplasia similar to adenoma? Can FNH’s show up in multiple areas of body? My first true diagnosis was thyroid cancer, later HRS and FNH in left lobe of liver. The hyper attenuating mass was 2.0 x 0.7 x 0.9 cm and changed to 2.1 x 9.4 x 1.1 cm in the last scan. I also have benign tumor and cysts in ovary. The thyroid nodules are reactive and enlarged lymph nodes in neck. My dad had kidney cancer, prostate and melanoma. Now, he is fighting CLL. My son, who is 10, had several 3+ cm lymph nodes in the neck removed. His doctors went on thinking lymphoma due to the size. It was benign, but he had a streptococcus bacteria. He also has cysts on his thyroid, which is under observation. Is there some relation or syndrome possible for this? Please explain.

 

 

Answered



Hi,

Welcome to dr.sitehome.info.

  • Following total thyroidectomy, you will be kept on lifelong thyroid replacement therapy and if the therapy is inadequate TSH levels will rise.
  • As long-term monitoring and to check the recurrence, the measurement of thyroid-stimulating hormone (TSH), thyroglobulin and antithyroglobulin antibodies titer need to be done.
  • Treatment consists of Levothyroxine in a dosage of 2.5 to 3.5 mcg/kg/day, which should be 125-175 mcg in your case.
  • Yes, FNH liver (focal nodular hyperplasia) exists and it is asymptomatic benign tumor of the liver.
  • The primary difficulty is to differentiate it from adenomas and liver cancer, which can be done by MRI, multiphasic CT and histology. Once confirmed no need for resection.
  • Thyroid follicular adenomas are real benign tumors. Neither pre-malignant nor carcinomas in situ, but its differentiation from follicular carcinoma is difficult and needs partial thyroid lobectomy and isthmusectomy for confirmation.
  • Ovarian cysts in female are more common.
  • Good to know about your son not having lymphoma, but it is reactive lymphadenopathy.
  • Coming to thyroid cysts, thyroid cysts are often thought to represent benign degenerative disease. They need an evaluation with a thyroid profile to know hormonal status, ultrasound neck, biopsy of the nodule and the most definitive test to determine whether a nodule is benign or malignant because of positive family history for cancer.

For further information consult an endocrinologist online –>https://www.dr.sitehome.info/ask-a-doctor-online/endocrinologist



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