Post-Thyroid Nodule Surgery: When to Seek Medical Attention?

Two years after thyroid nodule surgery, a follow-up ultrasound examination revealed findings?

In November 2021, I underwent surgery to remove a nodule from the right side of my thyroid.
The general situation is as follows: (Health record report) Thyroid, right side, excisional biopsy - nodular goiter.
The specimen received in formalin was a well-encapsulated thyroid nodule measuring 5.5 x 4 x 3.5 cm and weighing 36 grams.
I have been under continuous follow-up, and after the surgery, it was found that the nodule had caused hyperthyroidism, so I have been taking Procil 50 mg once daily.
Last Thursday, I had a follow-up appointment, and the doctor arranged for a neck ultrasound.
The ultrasound report from yesterday is as follows: Impression: Real-time ultrasound of the neck shows: Findings: > Prominent right thyroid lobe with a large nodule in it.
R/O nodular goiter.
> The right lobe measured 2.9 x 1.96 x 5.89 cm.
The left lobe measured 1.42 x 0.93 x 4.94 cm.
> Right thyroid hypoechoic nodule(s) (2.94 x 1.66 x 4.8 cm, 0.56 x 0.37 cm).
Recommend sonography follow-up.
> Left thyroid cyst (0.45 x 0.2 cm).
- The submandibular glands and parotid glands were unremarkable.
- Small lymph nodes (less than 1.67 cm) in bilateral neck, not specific.
[In conclusion] (1).
A large nodule (4.8 cm, post-FNA) in the right thyroid lobe showed no significant interval change in size compared to prior images.
Recommend close follow-up.
(2).
Small nodules and cysts (less than 0.6 cm) in both thyroid lobes.
Recommend sonography follow-up.
|------------------------------------ | The diagnosis was made by | comparing a current image | with a previous one | (thyroid ultrasound, 5/4/2022).
| Recommend regular thyroid ultrasound follow-up.
| - Since I have a long-term prescription, my next follow-up appointment should be on May 9.
Given that today is February 22, should I return to the clinic earlier for the doctor to address the findings in the ultrasound report?

Steven LEE, 40~49 year old female. Ask Date: 2024/02/22

Dr. Chen Bingze reply Surgery

Hello, I suggest you go back and ask the surgeon who performed your operation how much of the right thyroid was removed.
The current ultrasound report states [In conclusion] (1).
A large nodule (4.8 cm, post FNA) in the right thyroid lobe, which showed no significant interval change in size compared to prior images.
It seems that there is still a 4.8 cm nodule on the right side, which is necessary for evaluating the next steps.

Reply Date: 2024/02/22

More Info

After undergoing surgery for a thyroid nodule, it is crucial to monitor your health closely, especially if there are any changes in your condition or if you experience new symptoms. Based on your recent ultrasound report, there are several factors to consider regarding when to seek medical attention.

1. Changes in Nodule Size or Characteristics: Your ultrasound report indicates that there is a prominent nodule in the right thyroid lobe, measuring 4.8 cm, which has shown no significant interval change in size compared to previous images. However, it is essential to remain vigilant, as any increase in size or changes in the characteristics of the nodule could warrant immediate medical attention. If you notice any rapid growth or changes in the nodule's appearance, you should contact your healthcare provider.

2. Symptoms of Hyperthyroidism: You mentioned experiencing hyperthyroid symptoms post-surgery. Symptoms such as increased heart rate, anxiety, weight loss, or heat intolerance should be monitored closely. If these symptoms worsen or become unmanageable, it is advisable to seek medical attention sooner than your scheduled follow-up. Hyperthyroidism can lead to serious complications if left untreated, so timely intervention is critical.

3. New Symptoms: If you develop new symptoms such as difficulty swallowing, persistent neck pain, changes in voice, or any signs of swelling in the neck, these could indicate complications or changes in your thyroid condition. In such cases, it is essential to reach out to your healthcare provider immediately.

4. Follow-Up Recommendations: Your ultrasound report recommends regular follow-up with sonography. If your next scheduled appointment is in May and you have concerns based on your current symptoms or the ultrasound findings, it is reasonable to request an earlier appointment. Regular monitoring is vital for managing thyroid conditions effectively, especially after surgery.

5. Communication with Your Healthcare Provider: It is essential to maintain open communication with your healthcare team. If you feel uncertain about your current condition or the implications of the ultrasound findings, do not hesitate to reach out to your doctor for clarification. They can provide guidance on whether your symptoms or ultrasound results necessitate an earlier visit.

In summary, if you are experiencing any concerning symptoms or if there are changes in the size or characteristics of your thyroid nodules, it is advisable to seek medical attention sooner than your scheduled follow-up. Regular monitoring and proactive communication with your healthcare provider are key to managing your thyroid health effectively. Always prioritize your health and well-being, and do not hesitate to advocate for yourself in seeking the care you need.

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