Unexpected discovery of thyroid cancer during health check

Ho Chi Minh City Mr. Hai, 54 years old, had a health check and unexpectedly discovered early stage thyroid cancer.

Mr. Hai and his wife returned to Vietnam from the US to celebrate Tet. His wife had a general health check-up at Tam Anh General Hospital in Ho Chi Minh City, the results were normal, no disease was detected. On the way home from the hospital, his wife advised Mr. Hai to have a general check-up before returning to the US. At first, he refused because he felt normal, still played sports, and ate well. "My wife kept nagging me, so I agreed to go back to the hospital for a check-up to reassure her," Mr. Hai said.

Thyroid ultrasound results showed that Mr. Hai had multiple thyroid nodules in both lobes. The left lobe thyroid nodule was 3 cm in size, classified as TIRADS 4A (malignancy potential of about 5-10%). The patient underwent fine needle aspiration under ultrasound guidance, which showed hyperplastic thyroid epithelial cells forming a papillary structure, concluding papillary thyroid cancer.

On March 1, Master, Doctor, Specialist II Doan Minh Trong, Head and Neck Unit, said that Mr. Hai's disease was in the early stages, small in size, and the chance of living for more than 5 years was over 90% if treated early. In cases where it was detected late, the cancer would metastasize to the lymph nodes, spread to the lungs and bones, and would be difficult to treat. The patient would easily become physically and mentally exhausted.

Mr. Hai had surgery to remove both lobes of his thyroid gland. On the left lobe of the thyroid gland, there was a 3 cm nodule as shown on the ultrasound, clearly defined, and not yet invasive. On the right lobe of the thyroid gland, there was a 1 cm nodule, not yet invasive. The team used an ultrasound knife to cut the entire thyroid gland and sutured the wound for cosmetic purposes.

According to Dr. Minh Trong, the ultrasonic knife helps reduce bleeding, causes less damage to surrounding tissue, and shortens surgery time to 60 minutes compared to surgery with a conventional knife (about 2-3 hours).

Mr. Hai was discharged from the hospital 8 hours after surgery. The surgical results showed that the cancer had not spread, so the patient did not need additional treatment with radioactive iodine. However, because his entire thyroid gland had been removed, he would need to take thyroid hormone supplements for the rest of his life.

"Every cloud has a silver lining. Thanks to screening, I was able to detect the disease early," he said.

Doctor Trong asked about Mr. Hai's health after thyroid cancer surgery. Photo: Nguyen Tram — Doctor Trong asked about Mr. Hai's health after thyroid cancer surgery. Photo: *Nguyen Tram*

Thyroid cancer includes two types: well-differentiated thyroid cancer (papillary and follicular thyroid carcinoma) and poorly differentiated thyroid cancer (medullary, poorly differentiated and undifferentiated thyroid carcinoma).

Papillary thyroid carcinoma accounts for 80-85% of thyroid cancer cases, with a good prognosis. More than 90% of patients with papillary thyroid cancer live 10-20 years after treatment. Invasive papillary thyroid carcinoma metastasizes to nearby lymph nodes. About 10% of patients may show lymph node metastasis at the first examination, according to Dr. Trong.

In the early stages, thyroid cancer in general and papillary thyroid cancer often have no symptoms or appear as a lump or nodule on the neck. Most cases are detected through a general health check. In the late stages, symptoms include weight loss, difficulty swallowing, stuck in the neck..., with a high risk of metastasis to the lungs and bones.

Doctors recommend regular health screening to detect diseases at an early stage, treat promptly, and increase survival rates.

Nguyen Tram

* Patient's name has been changed

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