Noticed swollen thyroid gland (right) about six weeks ago.

Seeing a specialist in UMSC now. Blood test results came out normal, ultrasound shows a nodule in the thyroid gland, now pending for FNAC schedule.

I have been suffering from chronic cough and frequent headache since about a year ago. I could feel the nodule is growing larger in 6 weeks time, and started to have mild sore throats and a feeling of food sticking to the throat few days ago.

My problem with the existing doctor, is that he is only available twice a week, and every test in UMSC seems to have a long wait time.

Thinking to seek for second opinion. As I am considering to go for lobectomy regardless if the nodule is benign or malignant, it would be good to go straight to a second doctor which I feel comfortable to be operated by.

Any recommendation of good and skillful endocrinologist/ thyroid surgeon in Klang Valley? Would appreciate any advice. Thanks!

There must be an indication for removal of the nodule, which would be suggested by the endocrinologist to the practising thyroid surgeon. I don't think a surgery would be done for a benign nodule as risks outweighs the benefits. A

Anyway this is best to be discussed with the endocrinologist you are seeingt. If you want to see a new endocrinologist, then get the blood,ultrasound and FNAC reports from the endocrinologist in UMSC first. By the way, Hospital Putrajaya is the nation's referral centre for all endocrine cases, so you might want to think of going there.

Thanks for your advice. It did help to cool down a worried mind.

Long story short, FNAC report came back as suspicious of follicular neoplasm. I underwent an endoscopic hemithyroidectomy. Left with 3 unnoticeable surgical incisions, a burnt mark, lost a sensation nerve on my right shoulder. And a report that clears all my worries -- benign nodule.

Below are some info that I found out along my journey. Sharing it as this might be useful for someone else. But please note that these are my own experiences (Single nodule, non toxic, follicular neoplasm, age 30++, female). It is best to verify your condition with doctor and do your own research.

1) Is it necessary to go for surgery if FNAC result returns as suspicious?
-- 10% to 30% chances of malignancy. One can choose not to operate, but monitor periodically (ultrasound every 6 months or 1 year) for changes in size or shape. Or, hemithyroidectory (remove half of the thyroid) to confirm once and for all. Personal choice by patient.

2) Can I remove only the nodule instead of half of the thyroid gland?
-- If only nodule is removed, and results end up as malignant, the surgeon needs to go back to the previous operated location to clear away remaining thyroid tissue, risk is x10. So, either not operate at all, half or total. Never just the nodule.

3) Surgery options.
-- I checked out two options, conservative open surgery and distant endoscopic. Open surgery. Pro: Remove thyroid tissue more thoroughly. Minimum invasive. Con: 4 to 5 cm of scar at the neck......Distant Endoscopic. Pro: Few 5 mm to 1 cm scars at hidden locations, example armpit, breast. Con: Unable to "clean" thyroid tissue as thorough as open surgery. If RAI needed in future, need higher dose. More invasive, larger area of skin flap elevation.....If it is a known malignant nodule, distant endoscopic is not recommended. The only good about endoscopic is the invisible scar. I read that there is one type of surgery where incision is still at the neck, but guided by endoscopic so the cut is much smaller. Should be intermediate between the two, but I did not survey much on this.

4) Recommended surgeon?
-- I am pretty sure there are a lot of good surgeons out there. I have seen 4 specialists regarding my thyroid, and personally feel comfortable with below two.

Dr. Normayah Kitan (Sunway Medical Center)
- Previously HOD of surgical department in Putrajaya Hospital. A very patient and friendly lady. Endocrine and breast surgeon. Does only conventional open surgery for thyroidectomy.

Prof Dr. Rohaizak Muhammad (HUKM, UKMSC)
- Dr. Normayah was his student. Approachable and friendly. Endocrine and breast surgeon. Does both conventional open surgery and distant endoscopic thyroidectomy (through shoulder, armpit, breast).

You said FNAC was suspicious of follicular neoplasm. What did the histopathology say? Was it actually malignant?

Benign

Hi I am folowing your post. I am having the same problem as you do. May I know which doctor you saw initially for your thyroid problem ? Who are the doctors you saw subsequently till you did your surgery ?

Hi Jesm
Hope that you are fine now.
I am also having thyroid nodule with size 1-3 cm. Prof Rohaixxx give me the option of
1. thyroidectomy
2. Radioactive Iodine.
I am still considering...
May I know the cost for Endoscopic Thyroid surgery?
How is your condition now after your thyroid removed? any problem with the hormone replacement treatment?

HI Tony,

Would like to check what is your current condition and what decision you made for your case? And anymore finding for different options to treat your thyroid problem?
I am actually just found 2 nodules in my left thyroid (~1cm each), and another in my right thyroid (~5mm). The right side looks suspicious though I have not received the FNAC report.
From your post, as you mentioned one of the option is radioactive iodine, would this help? (earlier I thought this is to stops it from producing excessive thyroid hormones only. But will it help to destroying the nodules?)

Thanks in advance.

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This post has been edited by straw: Jul 4 2020, 10:11 AM