Re: surgery techniques-->

[Guest guest]

> I'm new to the group and dealing with the possibility of a thyca

> recurrence. I have had a recent ultrasound that showed abnormal

> structures and a CT scan confirming that. It seems like the best

> option is to have them removed, but my surgeon wants to go in

> through the old thyroidectomy scar, now that it has finally faded to

> barely noticeable!!

> I have heard people talking about neck dissections and other things,

> is it necessary to make such a huge incision to get at a couple of

> lymph nodes??

(snip)

Hi ,

Sorry to hear about your possible recurrence.

It's not unusual for the surgeon to go through the existing

thyroidectomy scar line depending on where the abnormal structures

are. Mine has been reopened twice since my original operation. When

I had repeat surgery in 1982, the surgeon removed the second thyroid

lobe and did an " en bloc " removal of the lymph nodes on one side (the

left side) through the original thyroidectomy line rather than make a

second cut and he left me with a better scar than the first surgeon. A

couple of years ago, I had a parathyroidectomy along (part of) the

same scar line. Although it's a very neat scar, the fact that the

surgeon opened it for only part of the way means it has ended up

slightly crooked :-( so there may even be an advantage to having the

incision reopened for its entire length, besides giving the surgeon a

better chance to look around. Another thing to bear in mind is that

there will inevitably be adhesions and internal scarring from the

first operation, making the navigation of your neck that bit trickier.

Is your surgeon experienced in reoperative neck surgery and does he do

a lot of (para)thyroidectomies? It is worth checking beforehand, and

if he is a general surgeon I would urge you to look around for an

appropriately experienced endocrine or head-and-neck surgeon.

has placed a diagram of the lymph nodes in the photos section of

the archive, see:

http://photos.groups.yahoo.com/group/Thyca/lst

Sorry I can't answer your MRI questions but I hope someone else can.

> no body scans since because of pregnancy/nursing

> ultrasound yearly showed nothing until this year . . .

I understand that many US doctors follow thyca patients more

aggressively, but here in Europe it is now exceptional to be routinely

scanned if the thyca first occurred below a certain age (around 45 I

believe) unless there are Tg antibodies or distant mets. I am followed

on Tg and ultrasound. I had a recurrence, but I'm still here and

looking forward to dancing at my grandchildrens' weddings always

provided my arthritic hip holds up ;-)

Hope this helps,

Judith (British, living in Holland)

dx 1965 pap thyca (T4-N1-M0)

pt 1965 (London England)

tt + rai 1982 (Alkmaar/Leiden, The Netherlands)

parathyroidectomy 2001 (London, England)