Thyroid nodules should be addressed promptly when discovered. A thyroid nodule is a lesion that grows in the thyroid, which is located in the front of the neck above the collar bones and below the Adam’s apple. Thyroid nodules occur frequently with a higher likelihood of developing with age. The vast majority are benign, but it is important to evaluate them properly as up to five percent are cancerous.
Most thyroid nodules present with no noticeable symptoms, and many are found on imaging studies of the neck. There are a few complaints, however, that can suggest a larger thyroid nodule. Swelling in the neck is the most common factor, and this can lead to pain at the site or possibly problems with swallowing or breathing.
The exact cause of benign, or non-cancerous, nodules is not known, but there are several factors that appear to be linked to their development. There seems to be a genetic link, and drinking alcohol and smoking can also increase risk. There may also be a link between uterine fibroids and thyroid nodules.
While only a small portion of nodules are cancerous, there are several elements that can increase the risk of a nodule being malignant. First, a nodule discovered in a child has twice the likelihood of being cancerous than one found in an adult. Also, thyroid nodules seen in a man are twice as concerning as those seen in women. Additionally, previous radiation treatment to the head or neck significantly increases the risk of malignancy. Finally, people who have family members with certain types of endocrine tumors or Garner’s syndrome have a higher potential of malignant thyroid nodules.
Many nodules are discovered by the patient or a doctor during a routine physical exam. Typically, the practitioner will order blood tests to evaluate how the thyroid is functioning and an ultrasound of the thyroid to better understand the nodule itself, such as size and solid or cystic nature.
Fine needle aspiration is the test of choice for further evaluation of a thyroid nodule. A specialist uses an ultrasound-guided needle to take a small sample of the nodule. This sample is sent off to a laboratory to be examined under a microscope and determine the tissue type. It is very accurate for determining if a nodule is benign, and it is even more accurate at detecting cancerous lesions. Occasionally, a thyroid scan with radioactive markers is performed to look at areas of thyroid hormone activity. This test is usually only done if there is an indication of Grave’s disease, or hyperthyroidism, which occurs when the thyroid is overactive and produces too much thyroid hormone.
For benign thyroid nodules, a physician usually recommends regular follow-up appointments. There are typically repeat thyroid ultrasounds at set intervals to evaluate the nodule’s progression. If the patient develops symptoms or the nodule increases significantly in size, then the doctor may recommend surgical removal of the lesion.
For malignant thyroid nodules, a surgeon usually removes that portion of the thyroid. If the pathology reports show cancer, the entire thyroid and neighboring lymph nodes may need to be removed. Close follow-up with a physician and thorough evaluation of the nodule and an individual’s health history will determine the treatment course that is needed.