Inquiry Regarding Pathology Report
Subject: Inquiry Regarding Pathology Report Diagnosis Summary: A. Right lobe of the thyroid and isthmus following a hemithyroidectomy: 1. Classic subtype of papillary thyroid carcinoma, measuring 1.3 cm, with narrow margins – refer to additional comment. 2. Presence of follicular nodular disease. B. Results from right central neck dissection: 1. Detection of metastatic papillary thyroid carcinoma in five out of ten lymph nodes (5/10). 2. Identification of benign thymic tissue. 3. Parathyroid tissue noted (1). After reviewing my pathology report, my physician advised a watchful waiting approach. I have several concerns: Why did the ultrasound fail to indicate any lymph node involvement? How can he justify a wait-and-see strategy if it wasn't revealed in the ultrasound results? What symptoms should I monitor to know if my lymph nodes are affected? Initially, I requested a complete thyroidectomy, but my doctor recommended against it due to heightened risks associated with the procedure. The prospect of just waiting is quite unsettling. Although this cancer type is known for slow growth, what are the chances that I might require another surgery in my situation? Would it be prudent to seek a second opinion or advocate for a total thyroidectomy?
Answers (1)
9/11/2025, 10:20:37 PM
OpenHealth AI
Your concerns about your pathology report and treatment plan are completely valid, and it's understandable to feel unsettled about the wait-and-see approach after such a diagnosis. Let's break down what you've shared and discuss some key points and next steps.
Main Points:
- Diagnosis Overview: You have papillary thyroid carcinoma, a type of thyroid cancer, with some metastasis to lymph nodes.
- Watchful Waiting Justification: Your doctor suggests monitoring rather than immediate further surgery, which typically involves assessing the growth of cancer and watching for symptoms.
- Concerns about Ultrasound and Symptoms to Monitor: It's common for an ultrasound to miss small metastatic nodes, and knowing what symptoms to look for can be key to managing your health.
Explanation:
Papillary thyroid carcinoma is generally known for its slow growth and favorable prognosis. The treatment strategy of watchful waiting may stem from multiple factors, such as the size of the tumor, your age, and overall health. Scans like ultrasounds can sometimes miss small metastases, which can be frustrating, but this is not uncommon in medical assessments.
Monitoring involves being vigilant for any new symptoms, such as:
- Swelling or lumps in the neck (especially around the thyroid or lymph nodes)
- Changes in voice (hoarseness)
- Difficulty swallowing or breathing
- Pain in the neck area
Your doctor may have anticipated that further surgery could pose significant risks given your current state. However, it is entirely reasonable to seek a second opinion, especially when facing such a critical health decision. A second opinion could help you understand more about your condition and evaluate whether further surgery may ultimately be beneficial.
Next Steps:
-
Monitor Symptoms: Keep a daily log of any new or changing symptoms. This will be valuable information for your next appointments.
-
Discuss Further Options: At your next appointment, express your concerns about the wait-and-see approach. Ask directly about the rationale for it and any specific criteria that would prompt intervention.
-
Seek a Second Opinion: Find another endocrinologist or oncologist who specializes in thyroid cancers. This can provide reassurance and additional insights into your treatment options.
-
Stay Informed: Research reliable sources regarding papillary thyroid carcinoma, treatment strategies, and lifestyle factors that can support your health.
Remember, it's important to feel comfortable and informed about your treatment plan. Advocating for yourself and seeking further clarification and opinions is a proactive approach to managing your health. If you have more questions or need further details, feel free to ask!
Related Questions
Seeking Answers for a Mysterious Health Concern
Subject: Urgent Assistance Needed! Every time I recline, I experience a sense of normalcy and comfort. However, when I’m in an upright position—whether standing or sitting—several troubling symptoms arise: my ears experience popping sensations, I suffer from neck discomfort, debilitating headaches, pervasive fatigue, mild dizziness, a foggy mind, and intense pain when I sneeze. Additionally, I notice increased heaviness in my head when I lean forward. I have undergone a comprehensive series of medical evaluations: - A brain MRI (both with and without contrast, including inner ear assessment) came back normal. - A neck CT scan showed no abnormalities. - My blood tests were all within standard limits. - An EKG returned clear results. - Vision examinations yielded no issues. - A neurological assessment showed no concerns. - Eye tests also produced normal results. As a 36-year-old physically active male, I find this situation perplexing and concerning. I am desperate for any insights or assistance you might offer!
Understanding the Risks of the Facial 'Danger Triangle'
I’m 32 years old, 170 cm tall, and weigh 65 kg. My current medications include Visanne for endometriosis, escitalopram, apprilon, and Allegra. Recently, I stumbled upon information regarding the "danger triangle" on the face, which highlights how infections in that region can result in severe complications such as cerebral venous thrombosis (CVT), stroke, or meningitis. This knowledge came thanks to a trending topic on social media. Now, I'm feeling quite anxious about it because I’ve noticed some pimples forming in that specific area. I generally avoid popping them, but the other night, one of them ruptured beneath a pimple patch. This particular spot was just to the left of my nose. After cleansing thoroughly while showering, I've experienced persistent discomfort under that area. I can’t determine whether the pain stems from the superficial skin or from the sinus cavity behind it; it’s been rather bothersome, especially since my skin has always been sensitive. The pimple in question was quite small and seems to have healed relatively quickly. However, I’m left with a burning sensation where it was located, and I'm unsure if this discomfort is related to the surface of my skin or deeper, possibly involving my sinuses. Notably, I haven't experienced any other symptoms. I’ve had acne in this area before, but it never caused me concern until I learned about this unsettling danger triangle. Any insights or advice would be greatly appreciated!
Questioning My Diagnosis: An Unexpected Journey
At 23, I experienced my initial flare-up in December 2023 while at my job. Being lactose intolerant, I made the unwise choice to consume dairy and spicy foods throughout the day. As my shift concluded, I began to feel discomfort in my lower right abdomen. This prompted a visit to the hospital where a few tests led the doctor to suspect diverticulitis, although he expressed uncertainty given my young age of 21. He subsequently recommended that I see a specialist. After undergoing a colonoscopy, I was diagnosed with Crohn’s disease. However, the doctor did not seem entirely confident in this conclusion. From then until April, my diet was severely restricted to just potatoes and rice. By early evening, fatigue would set in, and I lost weight not due to choice, but from a lack of appetite and fear of eating. Fortunately, after April, my health improved significantly, and I was able to resume my regular diet, albeit with increased caution regarding lactose consumption. In May, I also found out I was pregnant and welcomed my baby in January. During my pregnancy, I naturally gained weight and everything appeared normal—my lab results were good, and my baby is thriving. Personally, I've always carried a few extra pounds, but I make it a point to maintain an active lifestyle to manage my weight. Occasionally, I do experience a mild pinching sensation in my lower right abdomen, but it’s not unbearable—on a scale of 1 to 10, I’d rate it a mere 2. I share this because I have a lingering suspicion that my initial diagnosis may have been incorrect. I am not on any medications currently, nor have I made significant changes to my diet. I rarely feel fatigued anymore, and my husband often remarks on how energetic I seem. Is this experience common? Do others have insights or suggestions?
Seeking Guidance on Fungal Infection Treatment
I am a 22-year-old male, measuring 5 feet 5 inches tall and weighing 62 kg. I do not smoke or consume alcohol. Recently, I have been dealing with a recurring fungal infection. Approximately a year back, I consulted a physician who prescribed Itraconazole 200 mg along with various topical creams, which were adjusted after a week. After a treatment period of 2-3 months, the infection subsided; however, it has unfortunately returned and now appears in small patches on my buttocks, legs, and chest. I would like to know if it is safe for me to self-administer Itraconazole 200 mg along with Luliconazole cream for an extended period of 20 days or more without a new prescription. When I previously underwent treatment, I had a liver function test that showed normal results. Given the current situation, where the infection has not proliferated as extensively as before, would it be advisable to continue with Itraconazole for approximately 20 days to a month until the fungal infection resolves? I appreciate any guidance you can provide regarding this matter.
21-Year-Old Female with Extensive Symptoms: Seeking Clarity on Diagnosis
To start, I struggle with health-related OCD and have a confirmed diagnosis of Ehlers-Danlos Syndrome, verified by both my primary care doctor and a specialized physical therapist. I'm reaching out for some insights regarding my symptoms and whether they might point to serious conditions like cancer or neurodegenerative diseases. I recently began taking Lexapro and am feeling a significant amount of anxiety, particularly concerning sarcomas or cancers that have low survival rates, as well as conditions like ALS or other rare ailments. I am left wondering if my experiences are purely psychosomatic or if I should be consulting additional medical professionals. Here’s a compilation of the symptoms I’m experiencing: - Sharp, zapping discomfort throughout my body - Unexplained aches all over - Right inner thigh soreness - Persistent SI joint and upper buttock pain that has remained stable for two years - Electric shock sensations in various locations - Numbness and tingling when resting my hands on my hips in a T-rex posture; crossing my legs or awkwardly positioning my feet also triggers similar sensations - Prolonged tailbone pain (also two years) - Presence of cherry angiomas on my skin - A sensation akin to bugs crawling over my skin - Pain associated with plantar fasciitis - Zapping sensations in my genital region - Occasional involuntary body jerks - Muscle twitches and fasciculations - Discomfort located under my right breast that radiates to the mid-back, particularly notable since I had my gallbladder removed in April. I would greatly appreciate any perspective on whether these signs could indicate a serious health issue or whether they stem from heightened bodily awareness and anxiety.