Massive Thyroid Cystic Nodular Goiter in 2019.
Left Massive thyroid cystic nodule
Patient had a biopsy and after massive amount of fluid ( 725 ml) was removed with still a very soft residual solid amount left. Fluid removed was equal to 73 10 ml red top tubes!
The patient has avoided surgery for 10 years. During that time it continues to grow until now when the left lobe cystic nodule has caused her airpipe to be pushed way to the right. To cover her neck she presents with a scarf on. her mass feels firm and is resilient to touch and is not tender.
She traveled to Germany 3 months prior to her visit for a treatment rarely if ever used for simple papillary thyroid cancer that surgery was the treatment of choice. Called Transarterial Chemoembolization or TACE. She was treated with Mitomycin and Cisplatin injected into her thyroid arteries.
Chemotherapy is rarely needed for thyroid cancers, but never before surgery when is is found out to be an aggressive cancer. 3 months after that TACE procedure she still has hair loss from the chemotherapy!
What is TACE?
Transarterial Chemoembolization (TACE)
John’s Hopkins Doing TACE on as patient with liver cancer. The is no reports of TACE treatment for papillary thyroid cancer that is localized to the thyroid gland.
Transarterial chemoembolization or TACE places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor’s blood supply and trap the chemotherapy within the tumor. It is most often used to treat liver cancer but may also be used in patients whose cancer has spread to other areas of the body. Chemoembolization may be used as a standalone treatment or in combination with surgery, ablation, chemotherapy or radiation therapy.
It is never used for regular thyroid cancer in the US or Canada.
TACE failed and she is still left with a massive cystic goiter.
She wants ethanol ablation PEI to get rid of the cyst. Ultrasound guided biopsy, and mutation studies are pending to rule out cancer reported on a single biopsy done 10 years ago before considering PEI.
Stay tuned to further follow up on this patient’s results and treatment plan.
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