Thyroid Nodules

Overview

Thyroid nodules are solid or fluid-filled lumps that form in the thyroid gland. Most thyroid nodules are harmless; a small percentage are cancerous. Thyroid nodules often go unnoticed by the patient. They may be detected during a physical examination or imaging performed for other reasons.

Sometimes they can grow quite large and become visible from the outside. Treatment depends on the type of thyroid nodule.

Symptoms

• Most of the time, there are no signs or symptoms.
• If the nodule is large, there may be swelling in the neck and a choking sensation.
• Shortness of breath, difficulty swallowing, hoarseness and coughing may occur.
• Symptoms of toxic goiter due to excess thyroid hormone production may occur (such as weight loss, palpitations and sweating)

Causes

• Thyroid cyst
• Overgrowth of normal thyroid tissue (toxic adenoma)
• Hashimoto's disease (chronic inflammation of the thyroid)
• Multinodular goiter
• Thyroid cancer
• Iodine deficiency

Diagnosis

The diagnosis is easily made with a thorough medical history, physical examination, blood tests and a thyroid ultrasound. The key question for both the patient and the physician is whether the nodule is cancerous. For this, your physician may recommend a fine-needle aspiration biopsy of a nodule suspicious for cancer.

Treatment and Follow-up

Surgery is recommended for large nodules that cause compression symptoms such as shortness of breath and difficulty swallowing, and for nodules with a suspicious fine-needle aspiration biopsy result. If there is excess thyroid hormone production, anti-thyroid medications or radioactive iodine therapy may be an option. After surgery, depending on how much thyroid tissue remains, you may need to take synthetic thyroid hormone.