Is thyroidectomy the ONLY way to determine if a papillary lesion / follicular neoplasm is benign or malignant?

My wife recently underwent FNAB for the thyroid gland and the findings were:
1. PAPILLARY LESION
2. FOLLICULAR NEOPLASM.
Suggest thyroidectomy for a definitive diagnosis.
Microscopic Description:
Smears disclose a fairly cellular aspirate composed of cohesive clusters of follicular cells, in attempt to form acini and short papillary fronds. The cells show vesicular nuclei, with focal areas of pleomorphism. The background is hemorrhagic containing thin colloid materials and few mixed leukocytes.

I really would like to know if the it is benign or malignant but is there any other way besides invasive surgery? Thanks a lot in advance for all the answers and help.

If FNAB demonstrate follicular neoplasm , we must perform thyroid lobectomy for determining if it's malignant or not , and regarding to this , we will design the further definite and main operation .

There is no way other than this yet .

In some situations , we can perform total thyroidectomy as a plan to determine the permanent pathology at first ( there is several indications : old patients , mass more than 4 cm , ... ) .

But about Papillary neoplasm it's somewhat different : we can plan for a definite operation , also with a FNAB .

Yes, the entire lesion needs to be looked at and examined for cancer to be ruled out. The FNAB is only a small sampling of the the cells within the lesion. It does not represent the entire thing. It would be like looking at the Mona Lisa by cutting out the eyes. You could say it looks like it's the Mona Lisa, but can't be sure unless i look at the whole thing.

Depending on where the lesion is and who the surgeon is, your wife may only have half her thyroid taken out. If it is benign then she is done, if it is malignant they will often take out the other side. Some surgeons will elect to remove it entirely. Depends on several factors.

First I had a needle biopsy to determine if I was malignant or not. Finding that I was they scheduled the thyroidectomy. Please be your wife's advocate and tell them to anesthetize the area before the needle biopsy. I was told that the biopsy needles were so small it didn't make sense. I have had 8 surgeries and 3 kids, but the needle biopsy for thyroid cancer was the most brutal thing I've ever experienced. 9 different needles pushed through the muscles on the sides of my neck.. Be firm, please. And by the way, the thyroidectomy was a piece of cake comparatively! Good luck!

I had a lump on my thyroid and the FNA biopsy results showed papillary carcinoma (cancer). The pathologist at the hospital sent it to 2 other pathologists at the hospital. They also said it was papillary carcinoma. Then the pathologist sent it to USC's Thyroid Cancer Lab (we live in Los Angeles). They also said it was cancer. So after having several pathologists give their opinions, I was told to have a total thyroidectomy.

But my doctor wanted to "spare my feelings" so he didn't actually tell me I had cancer. He just said, "I recommend a total thyroidectomy." I had to ask another doctor to read the report and tell me exactly what I had. The other doctor said, "you have cancer. I'm sorry." Sometimes you have to ask them point blank, "tell me exactly what i have."

I was admitted to the hospital in the morning. Then I was given general anesthesia. The surgeon made a 2 inch incision in my neck and removed the cancerous portion first. The pathologist examined it, in the operating room, while I was still unconscious with my neck open. Once again, the pathologist confirmed that it was cancer. The surgeon then proceeded to remove the rest of my thyroid leaving just a very small amount attached to my voice box.

I spent 2 nights in the hospital in absolutely no pain. During the surgery, the nerves are cut so the patient feels no pain. It took almost 1 year for my nerves in my neck to start feeling anything.

If cancer is confirmed, a total thyroidectomy is definitely the way to go. Also, your wife should have RAI treatment to kill any remaining cancer cells. Thyca is a great resource at www.thyca.org.

Good luck.

mari

I had a suspicious result from a biopsy for papillary cancer so went ahead with the surgery. I opted to have the whole thing taken out, though you can also just have 1/2 taken out and if it's not cancer you may not need to take thyroid meds. Mine turned out to be cancer so it was a good decision to have it all taken out.

Have you met with a surgeon yet? In my case she was the most knowledgeable person to talk with. She looked at my biopsy results and gave me a more realistic view to how likely it was to be cancer, for example for me it was about a 70% chance it was cancer. Which is pretty high so that made it easier to opt for the surgery route.

The surgery wasn't that bad. Like other people mentioned I was in the hospital for 2 nights. It was very sore to swallow, like you have a giant lump in your throat, but that was the only real pain. It lasted for about 4-5 days. After a week I was pretty much back to normal. Someone else mentioned that the nerves in their neck were cut so it took a while for that feeling to come back - but that's not always the case, I didn't have any nerves cut.