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Denise Murphy: Small Thyroid Nodule

The Path to UPMC’s Multidisciplinary Thyroid Center (MTC)

By day, Denise Murphy works in health care. In her free time, she is a skilled soprano in her church choir.

Denise was diagnosed with a small nodule on her thyroid and took medication for 12 years to suppress the growth, leaving her still able to harmonize with her choir.

In 2007, however, Denise felt a change in the size of her thyroid and experienced continued neck discomfort and painful swallowing.

She scheduled an appointment with UPMC’s Multidisciplinary Thyroid Center (MTC) and ultimately underwent two fine needle aspiration (FNA) procedures, a standard procedure to collect tissue samples from the thyroid to determine if cancer is present.

The Challenge

Both Denise’s FNA biopsies were negative for cancer.

Due to her persistent discomfort, however, her endocrinologist ultimately sent a sample of her thyroid tissue, obtained from the FNA, to be tested for genetic mutations — a science pioneered by a UPMC pathologist that can indicate signs of an early cancer or a person's susceptibility to cancer.

Although Denise’s FNA results were negative, using the genetic mutation test, her tissue samples tested positive for the RAS mutation — a mutation that signals an increased risk for thyroid cancer or a hidden thyroid cancer.

The Solution

As a patient of the MTC, Denise had the benefit of cross-collaboration between key doctors that ultimately lead to a treatment plan.

Based on the genetic testing, the painful swallowing, and other complications — such as development of autoimmune thyroiditis (hypothyroidism) — Denise, along with her cancer care team, chose to have her entire thyroid surgically removed.

The Results

After surgery, the RAS-positive nodule in Denise’s thyroid tested positive for a papillary microcarcinoma, which — if left untreated — could have spread throughout the nodule and thyroid.

Like every surgery, the procedure had its risks. However, after a full recovery, Denise is able to sing again in her church choir.

*Denise is an employee of UPMC. All MTC patients have access to our state of the art care and treatment.