Thyroid nodule and Cancer cytology and surgical Pathology Reports: What Good Ones Should Include and When They May Have the Wrong Diagnosis

Thyroid nodule and Cancer cytology and surgical Pathology Reports: What Good Ones Should Include and When They May Have the Wrong Diagnosis

Dr.Guttler’s comments: Over 40 years treating patients with thyroid cancer and nodules I have encountered many “bad” cytology and surgical path reports. Reporting suspicious FNA findings resulting in unnecessary thyroid surgery. Rescue of a case with “bad” cytology report with a patient request for a second opinion BEFORE the surgery. A “bad” surgical path report caused the patient to be treated for 12 years for the wrong thyroid cancer ( papillary instead of medullary) causing her death, Another case asked for a second opinion before the treatment for papillary when a second opinion proved she had medullary cancer and was treated correctly.Here are the pearls from Dr. Mark Urken’s article.

1.It is important to make sure your disease has been diagnosed accurately to ensure that the treatment options offered are right for the specific disease.

2.Generally, pathology reports should display the type of cancer, the basic tumor features, whether there is evidence of blood vessels invaded by cancer, the number of lymph nodes evaluated and the number of pathologic nodes identified.

3.Over the years I have seen many “bad” cytology and pathology reports. I review all my patients reports and actual the slides.

4. Some patient’s were relieved they did not have cancer on second opinion.

5. Some left the hospital thinking they did not have cancer, but on pathology review second opinion they did have cancer.

6. Some had the diagnosis of the wrong cancer and were treated for it with the wrong methods.

7. Some with the wrong diagnosis thought to get opinions before beginning the wrong treatment regimen.

8. It all begins with the first cytology report and the first surgical pathology report. 

9.Please get second opinions before you go down the wrong treatment trail.

10. Call me at 310-393-8860 or email to thyroid.manager@thyroid.com for a second opinion BEFORE you have surgery.

Ask for Alicia

Dr.G.

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Mark Urken, MD, Chief of Mount Sinai Beth Israel’s Division of Head and Neck Oncology. Blog post
! http://www.healthbytesnyc.com/ear-nose-throat/thyroid-cancer-pathology-reports/

Posted on September 23, 2016 by Mount Sinai

Thyroid cancer is the most common endocrine cancer and it is one of the few cancers that has increased in incidence over recent years. Thyroid cancer occurs across all age groups, but is more common among people ages 20 to 55 and occurs more frequently in women. Before treatment begins, it is important to make sure your disease has been diagnosed accurately to ensure that the treatment options offered are right for the specific disease.

What Can Patients Expect from a Pathology Report?

A pathology report is a document that reflects the diagnosis determined by examining cells and tissues under a microscope, which allows the pathologist to describe the extent of a thyroid cancer and to appropriately stage the disease process. The pathologist prepares the report describing the size, shape and spread of the thyroid cancer. Generally, pathology reports should display the type of cancer, the basic tumor features, whether there is evidence of blood vessels invaded by cancer, the number of lymph nodes evaluated and the number of pathologic nodes identified.

If surgery is performed, the intraoperative findings identified by the surgeon should be communicated to all the clinicians involved in the care of a thyroid cancer patient so that they are better able to judge the virulence of the disease and to better judge the role of additional therapy as well as the intensity and frequency of the follow up. These pathology reports are only one piece of the puzzle in determining the type of treatment necessary as well as the risk of recurrence, with other factors such as age, gender, and general health status also contributing.

THANC Foundation: Helpful Resource for Patients with Thyroid Cancer

The THANC (Thyroid Head and Neck Cancer) Foundation, located at Mount Sinai Beth Israel, has developed the Thyroid Care Collaborative (TCC), an online program for thyroid cancer patients. The TCC improves care by allowing healthcare professionals to easily share information in one convenient and secure location. This unified record helps to prevent duplication of testing and ensures all physicians involved in the care of the patient are well-informed. The TCC also allows patients to view their medical documents, including pathology reports, lab reports, and ultrasounds. Patients gain access to an extensive video library, written by experts in thyroid cancer management. The videos contain information about thyroid cancer, available treatment, and follow-up care. Patients gain valuable information on what to expect through their thyroid cancer journey, ensuring that they receive essential and best possible care.

Comments:
Over the years I have seen many “bad” cytology and pathology reports. I review all my patients reports and actual the slides. Some patient’s were relieved they did not have cancer on second opinion.Some left the hospital thinking they did not have cancer ,but on my pathology review second ooinion they did have cancer. Some had the diagnosis of the wrong cancer and were treated for it with the wrong methods. Some with the wrong diagnosis thought to get opinions before beginning the wrong treatment regimen. It all begins with the first cytology report and the first surgical pathology report. Please get second opinions before you go down the wrong treatment trail.

Richard Guttler MD,FACE,ECNU
Call Matthew for details of a second opinion before you begin treatment.310-393-8860