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The patient, a 28-year-old male, is usually in good health and has not had a thyroid ultrasound examination.
In September 2021, the patient participated in the physical examination, and thyroid ultrasound suggested that the right lobe nodule morphology was not good, and the physical examination doctor recommended to go to the hospital for further review.
Therefore, the patient came to The China-Japan Hospital to review thyroid ultrasound and ultrasound imaging tips: there is a knot in the middle of the right lobe of the thyroid gland that saves 0.8 cm, close to the tracheal wall, the boundary is not clear, the morphology is irregular, which is a typical malignant morphological feature. Subsequent nail puncture suggests papillary carcinoma of the right lobe of the thyroid gland.
On examination: a nodule about the size of a finger is palpable in the middle of the right lobe of the thyroid gland, hard, close to the side wall of the trachea, underactive
For such a diagnosed malforated thyroid papillary carcinoma, the recommendation is: surgery!
The patient's surgery is pending
【Reviews】
In the outpatient clinic, patients often encounter patients who ask such a question: Doctor, my thyroid cancer has just been discovered, the cancer nodule is relatively small (microcarcinoma) and there are no symptoms of discomfort, can it be observed?
For this question, it is difficult to answer clearly in a few words!
However, the simple explanation is as follows:
1. Theoretically, papillary thyroid cancer can be "observed"!
However, it is worth noting that its observations have certain prerequisites. For example, thyroid cancer nodules just grow within the thyroid parenchyma, cancer foci do not invade the thyroid membrane, cervical lymph nodes do not metastasize, and should be reviewed regularly every 3 to 6 months
Think about it: how many thyroid cancer patients in the clinic meet the above observation conditions?
Taking a step back, even if some patients barely meet the observation conditions, patients not only insist on long-term review, but also bear great pressure in their hearts, live in the fear of "cancer", once metastasis occurs, the effect of re-operation will be greatly reduced, and many people are difficult to insist!
2. The damage of thyroid cancer to the human body is not necessarily related to the size of the cancer nodule. Clinically, microcarcinoma of the thyroid gland also presents with cervical lymph node metastases.
3. If the thyroid cancer nodule grows on the dorsal side of the thyroid gland, close to the trachea esophagus, close to the recurrent laryngeal nerve, and invades the thyroid membrane, that is to say, we say that the location is not good for thyroid cancer, even if the cancer foci are relatively small, if the thyroid cancer with a bad position is diagnosed, it is not recommended to observe in principle, and operate as soon as possible!
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Chief Physician of The Department of General Surgery of China-Japan Friendship Hospital
About Dr. Lu Yao
Dr. Lu Yao is the chief physician and professor of the Department of General Surgery of China-Japan Friendship Hospital.
In Sino-Japanese Hospital, it has taken the lead in carrying out cervical scar-free endoscopic thyroid surgery, endoscopic radical thyroid cancer resection, endoscopic hyperthyroidism and parathyroid surgery, and has accumulated more than 10,000 cases of thyroid surgery, more than 2,000 cases of endoscopic thyroid surgery, and more than 600 cases of primary and secondary hyperparathyroidism surgery.