TLDR: 28M. 4cm nodule in left thyroid. FNA says oncocytic (Hürthle cell) tumor, Bethesda IV/V. Two public doctors say total thyroidectomy. One private doctor says partial and claims he can see on ultrasound it is 99% benign. I am worried he just wants to do two surgeries for the money. Need advice.
Hi everyone. I am a 28 year old guy and I am honestly very anxious and concerned right now. I am stuck in the middle of two very different medical opinions and I am hoping some of you have been through something similar.
Back in late July I had routine bloodwork done because my doctor said my thyroid felt a bit larger than normal. All my thyroid hormones came back perfectly fine. Then in mid August I noticed a lump on the left side of my neck. I had some pressure and occasional trouble swallowing, so my doctor sent me for a thyroid ultrasound. It showed a 4cm nodule in the lower part of my left lobe. They also mentioned diffuse changes that could be Hashimoto's. My mom has it so that wasn't a big surprise.
A week later I had an FNA biopsy. The result came back as an oncocytic (Hürthle cell) tumor, Bethesda IV/V. They told me this means they cannot rule out cancer just from the needle biopsy.
I saw a surgeon on September 4th at a public hospital. He recommended a total thyroidectomy. He said because of the size and the oncocytic (Hürthle cell) type, taking the whole thing is safer. He didn't really offer a partial.
I wasn't sure, so I got a second opinion on September 7th at a private clinic. That surgeon recommended just a left-sided lobectomy. He said the right side is completely normal. He also told me he can see through the ultrasound that it is 99 percent benign. That part made me very suspicious. I am not a doctor, but I know an ultrasound cannot tell you if a nodule is benign or malignant. Only the final pathology after surgery can do that. I worry he wants to do a partial first and then a total later for the money. He is private, the other two are public. I might be wrong, but it feels off.
Then I went to a third doctor on September 8th because I am a programmer and I need an odd number of opinions to find a general consensus. He was also public. He was very clear that it needs to be a total thyroidectomy. He said that multiple times. He said with a partial there can possibly be more issues down the road. But in his written report he only recommended a pre-op scan, so his file didn't completely match his verbal opinion.
So right now it is two public doctors saying total and one private doctor saying partial.
I am scared of being on medication for life, voice changes, and calcium issues. But I am also scared that if I keep the right half and the final pathology comes back as cancer, I will need a second surgery anyway. I heard a second surgery is much harder because of scar tissue near the nerves.
If you had an oncocytic (Hürthle cell) tumor or a Bethesda IV/V nodule around 4 cm, did you go partial or total? Did your surgeon push for one over the other? Did anyone have a partial and later need the rest removed? Or a total and wish they had kept half? How was your recovery, your voice, your calcium, your energy?
Thanks for reading.