Dr. Guttler: Thyroid Cancer - Lessons On What Can Go Wrong With Mutiple Unnessary Surgeries
An True Example On What Can Go Wrong:
A 39 year old female has a lump found below her right ear.
Problem #1: An excision biopsy was done by an ENT without any ultrasound, or fine needle biopsy. It was a papillary thyroid cancer in a level 2 node. The patient was then referred to an endocrinologist. He saw the results of the node biopsy, and told her she needed her thyroid out.
Problem #2: There was no detailed lymph node mapping done before the referral to the surgeon.
Problem #3: The surgeon,knowing there was a proven cancer node high up in the neck removed by the ENT, did not include a modified radical neck on the side of the cancerous node removed.
Problem #4: When the surgeon took out the thyroid cancer, he was confronted with 3 lateral neck nodes that were next to the thyroid. This was his second chance to do a modified neck on that side, but he decided to take the easy way out and only cherry picked the 3 abnormal nodes.
Problem #5: While removing the thyroid with the cancer, he came across 2 very abnormal nodes in the thyroid bed. They were positive for cancer, and again he failed to do the right thing and do a complete central compartment node removal.
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