Thyroid nodules

Description

Thyroid nodules are solid or fluid-filled lumps that form within your thyroid, a gland located at the base of your neck just above the breastbone.

The majority of thyroid nodules aren't serious and don't cause symptoms. Only a small percentage of thyroid nodules are cancerous.

Often, you didn't know you have a thyroid nodule until your doctor discovers it during a routine medical examination. Or the doctor may be discovered during an analysis that was done for another reason of health. Some thyroid nodules, however, may be large enough to be visible or make it difficult for you to swallow or breathe.

The treatment options depend on the type of thyroid nodule that has.

Symptoms

Most thyroid nodules do not cause signs or symptoms. But every once in a while some nodes become so large that they can:

  • Felt
  • Be seen, often as a swelling at the base of your neck
  • Press on the trachea or the esophagus, causing shortness of breath or difficulty swallowing

In some cases, the nodules in the thyroid to produce thyroxine, a hormone secreted by the thyroid gland. The extra thyroxine can cause symptoms of overproduction of thyroid hormones (hyperthyroidism), such as:

  • Unexplained weight loss
  • Increased sweating
  • Tremor
  • Nervousness
  • Rapid or irregular heartbeat

Only a small number of thyroid nodules are cancerous. But the determination of that cancerous nodules can't be done through the evaluation of your symptoms. The majority of cancerous thyroid nodules are slow-growing and can be small when the doctor discovers them. Aggressive thyroid cancers are rare with nodules that can be large, firm, fixed and fast growth.

When to see a doctor

Although the majority of thyroid nodules are benign and do not cause problems, consult your physician to assess any swelling in the neck, especially if you have difficulty breathing or swallowing. It is important to assess the possibility of cancer.

Seek medical attention if they develop signs and symptoms of hyperthyroidism, such as:

  • Sudden loss of weight, despite the fact that his appetite is normal or increased
  • Pounding heart
  • Sleep problems
  • Muscle weakness
  • Nervousness or irritability

Also consult with your doctor if you have signs and symptoms that may indicate that the thyroid gland is not making enough thyroid hormone (hypothyroidism), which include:

  • Feeling cold
  • Feeling tired more easily
  • Dry skin
  • Memory problems
  • Depression
  • Constipation

Causes

Various conditions can cause nodules develop in the thyroid gland, including:

  • The overgrowth of normal thyroid tissue.An overgrowth of normal thyroid tissue is sometimes referred to as a thyroid adenoma. It is not clear why this occurs, but it is not cancerous and is not considered fatal, unless cause annoying symptoms of its size. Some of adenomas of the thyroid lead to hyperthyroidism.
  • The thyroid cyst. Fluid-filled cavities (cysts) in the thyroid most commonly the result of the degeneration of the thyroid adenomas. Often, solid components are mixed with the liquid in the thyroid cysts. The cysts are usually benign, but they occasionally contain malignant solid components.
  • The chronic inflammation of the thyroid gland. Hashimoto's disease, a thyroid disorder, can cause inflammation of the thyroid and result in the enlargement of the nodules. This is often associated with hypothyroidism.
  • Multinodular Goiter. The term goiter is used to describe any enlargement of the thyroid gland, which can be caused by iodine deficiency or a thyroid disorder. A multinodular goiter contains multiple nodules in the goiter, but its cause is less clear.
  • Cancer of the thyroid.The probability that a nodule is cancerous are small. However, a nodule is big and hard, or causes pain or discomfort is more worrying. It is likely that you want to have it checked by your doctor. Certain factors increase the risk of thyroid cancer, such as family history of thyroid or other cancers, endocrine, and have a history of exposure to radiation from medical treatment or the fallout.
  • The deficiency of iodine. The lack of iodine in the diet can sometimes cause the thyroid gland to develop nodules in the thyroid. But iodine deficiency is uncommon in the united States, where iodine is routinely added to table salt and other foods.

The overgrowth of normal thyroid tissue. An overgrowth of normal thyroid tissue is sometimes referred to as a thyroid adenoma. It is not clear why this occurs, but it is not cancerous and is not considered fatal, unless cause annoying symptoms of its size.

Some of adenomas of the thyroid lead to hyperthyroidism.

Cancer of the thyroid. The probability that a nodule is cancerous are small. However, a nodule is big and hard, or causes pain or discomfort is more worrying. It is likely that you want to have it checked by your doctor.

Certain factors increase the risk of thyroid cancer, such as family history of thyroid or other cancers, endocrine, and have a history of exposure to radiation from medical treatment or the fallout.

Complications

The complications associated with some of the nodules of the thyroid are:

  • Problems with swallowing or breathing. Large nodule or a multinodular goiter may interfere with swallowing or breathing.
  • The hyperthyroidism.Problems can occur when a nodule or goiter produces thyroid hormone, which leads to an excess in the amount of the hormone in the body. Hyperthyroidism can result in weight loss, muscle weakness, heat intolerance, and states of anxiety or irritability. The potential complications of hyperthyroidism include an irregular heartbeat, weak bones and crisis thyrotoxic storm, a rare but potentially deadly, the intensification of the signs and symptoms that require immediate medical attention.
  • Problems related to the thyroid nodule surgery. If your doctor recommends surgery to remove a node, you may need to take the replacement therapy of thyroid hormone for the rest of your life.

The hyperthyroidism. Problems can occur when a nodule or goiter produces thyroid hormone, which leads to an excess in the amount of the hormone in the body. Hyperthyroidism can result in weight loss, muscle weakness, heat intolerance, and states of anxiety or irritability.

The potential complications of hyperthyroidism include an irregular heartbeat, weak bones and crisis thyrotoxic storm, a rare but potentially deadly, the intensification of the signs and symptoms that require immediate medical attention.

Thyroid nodules

Diagnosis

In assessing a lump or nodule in your neck, one of your doctor's main goal is to rule out the possibility of cancer. But your doctor will also want to know if your thyroid works properly. The tests include:

  • Test físico.Su doctor will likely be asked to swallow while he or she examines your thyroid because a nodule in your thyroid gland will usually move up and down during swallowing. Your doctor also will look for signs and symptoms of hyperthyroidism, such as tremor, overly active reflexes, and a rapid or irregular heartbeat. He or she is also the presence of signs and symptoms of hypothyroidism, such as a slow heartbeat, dry skin and swelling of the face.
  • Thyroid function tests. Tests that measure the blood levels of thyroid-stimulating hormone (TSH) and the hormones produced by the thyroid gland can also indicate if you have hyperthyroidism or hypothyroidism.
  • Ultrasound. This imaging technique uses high-frequency sound waves to produce images of your thyroid gland. A thyroid ultrasound provides the best information about the shape and structure of the nodules. Doctors can use to distinguish cysts from solid nodules or to determine if multiple nodules are present. Doctors can also use as a guide in performing a fine-needle aspiration biopsy.
  • Fine-needle aspiration biopsy.The nodules are often the biopsy to make sure there is no cancer present. During the procedure, the doctor inserts a very fine needle into the nodule and removes a sample of cells. The procedure is usually done in your doctor's office, it takes around 20 minutes and has few risks. Often, your doctor will use ultrasound to help guide the placement of the needle. Then, your doctor will send the samples to a laboratory for analysis under a microscope.
  • Scan tiroides.Su doctor may recommend a thyroid scan to help evaluate thyroid nodules. During this test, an isotope of radioactive iodine is injected into a vein in your arm. Then, you will lie on a table while a special camera that produces an image of the thyroid on a computer screen. The nodules that the production of an excess of the thyroid hormone called hot nodules — are displayed in the scan, as they carry more of the isotope than normal thyroid tissue does. Hot nodules are almost always benign. In some cases, the nodules that take up less of the isotope called cold nodules are cancerous. However, a thyroid scan can not distinguish between cold nodules cancerous and non-cancerous.

Physical exam. Your doctor will likely be asked to swallow while he or she examines your thyroid because a nodule in your thyroid gland will usually move up and down during swallowing.

Your doctor also will look for signs and symptoms of hyperthyroidism, such as tremor, overly active reflexes, and a rapid or irregular heartbeat. He or she is also the presence of signs and symptoms of hypothyroidism, such as a slow heartbeat, dry skin and swelling of the face.

Fine-needle aspiration biopsy. The nodules are often the biopsy to make sure there is no cancer present. During the procedure, the doctor inserts a very fine needle into the nodule and removes a sample of cells.

The procedure is usually done in your doctor's office, it takes around 20 minutes and has few risks. Often, your doctor will use ultrasound to help guide the placement of the needle. Then, your doctor will send the samples to a laboratory for analysis under a microscope.

Scintigraphy of the thyroid. Your doctor may recommend a thyroid scan to help evaluate thyroid nodules. During this test, an isotope of radioactive iodine is injected into a vein in your arm. Then, you will lie on a table while a special camera that produces an image of the thyroid on a computer screen.

The nodules that the production of an excess of the thyroid hormone called hot nodules — are displayed in the scan, as they carry more of the isotope than normal thyroid tissue does. Hot nodules are almost always benign.

In some cases, the nodules that take up less of the isotope called cold nodules are cancerous. However, a thyroid scan can not distinguish between cold nodules cancerous and non-cancerous.

Treatment

The treatment depends on the type of thyroid nodule that has.

The treatment of benign nodules

If a thyroid nodule is not cancerous, treatment options include:

  • Watchful waiting.If the biopsy shows that you have a thyroid nodule benign, your doctor may suggest the simple observation of its condition. This usually means having a physical examination and thyroid function tests at regular intervals. You can also include an ultrasound exam. You are also likely to have another biopsy if the nodule grows larger. If a thyroid nodule benign remains unchanged, you may never need treatment.
  • Thyroid hormone therapy. If your proof of function of the thyroid is the gland does not produce enough thyroid hormone, the doctor may recommend thyroid hormone therapy.
  • Surgery. A benign nodule may sometimes require surgery if it is so large it makes it hard to breathe or swallow. Doctors may also consider surgery for people with large multinodular goiter, particularly when the goiter airways contract, the esophagus, or the blood vessels. Nodules are diagnosed as indeterminate or suspicious for a biopsy also the need for surgical removal, so that they can be examined for signs of cancer.

Watchful waiting. If the biopsy shows that you have a thyroid nodule benign, your doctor may suggest the simple observation of its condition.

This usually means having a physical examination and thyroid function tests at regular intervals. You can also include an ultrasound exam. You are also likely to have another biopsy if the nodule grows larger. If a thyroid nodule benign remains unchanged, you may never need treatment.

The treatment of nodules that cause hyperthyroidism

If a nodule in the thyroid is the production of thyroid hormones, the overhead of the normal thyroid gland, the levels of production of hormones, your doctor may recommend treatment for hyperthyroidism. This may include:

  • The radioactive iodine. The medical use of radioactive iodine to treat hyperthyroidism. Taken in the form of capsules or in liquid form, the radioactive iodine is absorbed by the thyroid gland. This causes nodules to shrink and the signs and symptoms of hyperthyroidism to decrease, usually within two to three months.
  • Anti-thyroid medications. In some cases, your doctor may recommend an anti-thyroid medication such as methimazole (Tapazole), to reduce the symptoms of hyperthyroidism. The treatment is usually long-term and can have serious side effects on the liver, so it is important to discuss the treatment of the risks and benefits with your doctor.
  • Surgery. If the treatment with radioactive iodine or anti-thyroid medications is not an option, you may be a candidate for surgery to remove the nodule of the thyroid overactive. It is likely that discuss the risks of surgery with your doctor.

The treatment of cancerous nodules

The treatment for a nodule is cancerous generally involves surgery.

  • Of the observation. Very small cancers have a low risk of growth, so that may be suitable for your doctor to see up close cancerous nodules before treatment of them. This decision is often done with the help of a specialist in thyroid. The observation includes the ultrasound control and performing blood tests.
  • Surgery.A common treatment for cancerous nodules is the surgical removal. In the past, it was standard to remove a majority of thyroid tissue — a procedure called near-total thyroidectomy. However, today more and more limited surgery to remove only half of the thyroid gland may be appropriate for some of cancerous nodules. Near-total thyroidectomy may be used depending on the extent of the disease. Risks of thyroid surgery include damage to the nerve that controls the vocal cords and the damage to your parathyroid glands — four small glands located in the posterior part of the thyroid, which helps with the control of his body, the levels of minerals, such as calcium. After a thyroid surgery, you need life-long treatment with levothyroxine, in order to supply your body with thyroid hormone. Your thyroid specialist will help you determine the correct amount to take because it may require more of a hormone replacement for managing your cancer risk.
  • Alcohol ablation. Another option for the management of certain small nodules cancerous is alcohol ablation. This technique involves injecting a small amount of alcohol in the cancerous thyroid nodule in order to destroy it. Multiple treatment sessions are often required.

Surgery. A common treatment for cancerous nodules is the surgical removal. In the past, it was standard to remove a majority of thyroid tissue — a procedure called near-total thyroidectomy. However, today more and more limited surgery to remove only half of the thyroid gland may be appropriate for some of cancerous nodules. Near-total thyroidectomy may be used depending on the extent of the disease.

Risks of thyroid surgery include damage to the nerve that controls the vocal cords and the damage to your parathyroid glands — four small glands located in the posterior part of the thyroid, which helps with the control of his body, the levels of minerals, such as calcium.

After a thyroid surgery, you need life-long treatment with levothyroxine, in order to supply your body with thyroid hormone. Your thyroid specialist will help you determine the correct amount to take because it may require more of a hormone replacement for managing your cancer risk.

Preparing for your appointment

If you see or feel a nodule of the thyroid itself — usually in the middle of the lower part of the neck just above the breastbone — call your primary care doctor for an appointment to assess the lump.

Often, your doctor can discover thyroid nodules during a routine medical examination. Sometimes, your doctor detects a thyroid nodule when you have a test diagnostic imaging, such as ultrasound, computed tomography or magnetic resonance imaging, to evaluate another condition on the head or neck. Nodules are detected in this way are generally smaller than those found during a physical exam.

Once the doctor finds a nodule in the thyroid, it is likely to be referred to a doctor trained in endocrine disorders (endocrinologist). To get the most out of your appointment, try these tips:

  • Be aware of any pre-appointment restrictions. At the time of making your appointment, be sure to ask if there is anything that you need to do in advance to prepare for the diagnostic tests that you may have.
  • Write down all the symptoms and the changes you're experiencing, even if it seems to not be related to your current problem.
  • Make a list of important medical information, including surgical procedures, the names of all the medications you are taking, and any other conditions for which it has been treated.
  • Take note of your personal and family medical history, including any history of thyroid disorders and thyroid cancer. Tell your doctor of any exposure to radiation may have had, whether as a child or an adult.
  • Write down questions to ask your doctor. For example, it is likely that you want to know if the nodules that do not cause problems in need of treatment, and what treatment options are available.
Symptoms and treatment of Thyroid nodules