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Meta
Răspunsuri la întrebări (2000)
October 27, 2019
Maria Tomoioaga:
Buna dimineata !Va rog, dati-mi si mie un raspuns !
In urma cu un an am suferit o tiroidectomie totala.La examinarea histopatologica a fost identificat un nodul microfolicular de 0,5 cm ( din peste 20 , de marimi diferite ,in ambii lobi) , citez ,,ce pate fi sugestiv pentru un Microcarcinom papilar “.Mi s-a recomandat efectuarea cloratiilor imunohistochimici pentru CK19 si CD56 pentru probarea sau infirmarea suspiciunii de Microcarcinom papilar tiroidian.Doctorul chirurg m-a asigurat ca nu este nevoie , deoarece orice problema ar fi existat, a fost indepartata chirrgical.Acum, la un an, am facut o pauza de Etiraox de 18 zile , am refacut analizele cu urmatoarele rezultate :
TSH:-11,832 uUI/ml Valori de referinta :0,5-7.3
FT4:-0,32 0,6-1,2
Anti tiroglobulina:<0,9 0-4
Tiroglobulina: 1,61 3,5-77ng/ml-valori normale
<0,04-la pacientii atiroidieni
Marturisesc ca imi este un pic teama.Tg n-ar trebui sa fie nedetectabil ? Mululumesc !
Raspuns:
- in esenta, chirurgul a avut dreptate; un focar de carcinom papilar de 5 mm, care nu este situat in apropierea capsulei tiroidiene, se poate considera eliminat complet prin operatie si nu necesita tratament cu iod radioactiv;
- tiroglobulina devine nedetectabila la pacientii care au primit cel putin un tratament cu iod radioactiv; la ceilalti, cum e si cazul dvs, gasim o valoare mica, concordant cu micile resturi de tesut tiroidian care raman inevitabil dupa operatie;
- la dvs, monitorizarea ar trebui sa fie in primul rand ecografica, cu tiroglobulina recoltata sub Euthyrox anual; daca ecografic nu sunt modificari suspecte si tiroglobulina se mentine (relativ) constanta (chiar daca detectabila!), masurarea pe intrerupere de Euthyrox ar trebui luata in considerare la 2-3 ani;
Toate cele bune,
Dr. Cristian-Claudiu Ţupea – Click aici pentru consultaţii
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