Thyroid Lumps (Nodules) Treatment & Surgery

Thyroid nodules are lumps that commonly arise within an otherwise normal thyroid gland. Often detected by imaging studies or felt as a lump in the throat, most thyroid nodules are benign (non-cancerous) and asymptomatic, but a small percentage can be cancerous or cause thyroid dysfunction. Understanding the nature, diagnosis, and management of thyroid nodules is crucial, as their presence can significantly impact thyroid function and overall health.

Nature of Thyroid Nodules

Thyroid nodules can vary greatly in size and nature. They may be solid or filled with fluid (cystic), and they can occur singly or as multiple nodules within the gland, known as multinodular goitre. While the exact cause of most thyroid nodules is unknown, factors like iodine deficiency, radiation exposure, and hereditary conditions can contribute to their development.

Symptoms

Most thyroid nodules do not cause symptoms and are often discovered incidentally during a physical examination or imaging for an unrelated reason. However, some nodules may become large enough to be noticeable or cause symptoms such as:

• A visible lump in the neck
• A sensation of pressure or tightness in the throat
• Difficulty swallowing or breathing, especially when lying down
• Hoarseness or voice changes
• In some cases, thyroid nodules can produce thyroid hormones, leading to symptoms of hyperthyroidism, such as unexplained weight loss, increased heart rate, sweating, and nervousness.

Diagnosis

The evaluation of a thyroid nodule typically involves a combination of clinical assessment, imaging, and laboratory tests:

• Thyroid Function Tests: Assess the gland’s hormone production levels to determine if the nodule is affecting thyroid function.
• Ultrasound: A key imaging tool that helps in assessing the size, number, and characteristics of nodules, differentiating between solid and cystic nodules, and identifying features suggestive of malignancy.
• Fine-Needle Aspiration Biopsy (FNAB): A minimally invasive procedure where a thin needle is used to retrieve cells from the nodule. This is the most reliable way to determine if a nodule is benign or malignant.
• Thyroid Scan: Involves the use of radioactive iodine or technetium to evaluate nodule function and is particularly useful for nodules causing hyperthyroidism.

Treatment

The treatment for thyroid nodules depends on their size, type, and whether they produce excess thyroid hormones or are cancerous:

• Observation: Small, benign nodules that don’t cause symptoms may simply be monitored over time with periodic ultrasounds.
• Thyroid Hormone Suppression Therapy: In some cases, synthetic thyroid hormone levothyroxine is prescribed to suppress TSH, a hormone that can stimulate nodule growth, although this treatment is somewhat controversial and not universally recommended.
• Radioactive Iodine: Used to treat nodules that are hyperfunctioning or contribute to hyperthyroidism.
• Ethanol Ablation: Involves injecting alcohol into the nodule to reduce its size, typically used for cystic nodules.
• Surgery: Recommended for nodules that are cancerous, suspected to be cancerous, or cause significant symptoms due to their size. The extent of surgery can vary from removing a portion of the thyroid (lobectomy) to removing the entire gland (thyroidectomy).

Prevention and Management

While it’s not always possible to prevent thyroid nodules, regular medical check-ups can aid in early detection and management. For individuals with thyroid nodules, maintaining a healthy lifestyle and regular monitoring are key components of management. It’s important to follow the recommended schedule for ultrasound examinations and, if applicable, take thyroid hormone medications as prescribed.

Conclusion

Thyroid nodules are a prevalent condition that can range from benign growths requiring minimal intervention to cancerous nodules needing surgical removal. Early detection and appropriate evaluation are critical to determine the nature of the nodule and guide treatment decisions. With advances in diagnostic techniques and treatment options, most people with thyroid nodules can lead healthy, normal lives. If you discover a lump in your neck or experience symptoms suggestive of a thyroid nodule, it’s important to consult an ENT specialist in Singapore for a thorough evaluation.