Thyroid Nodules
Overview
The thyroid gland is a butterfly shaped gland in the neck just below the voice box. Thyroid gland produces hormone that is required for our metabolism with under or over hormone secretion both causing physical problems.
Thyroid nodules are abnormal lumps (growths) within the thyroid gland. This is a very common condition seen in approximately 30% of adults. These are more commonly seen in females. There can be single or multiple thyroid nodules.
Most thyroid nodules are benign growths. They usually are non-functioning and do not affect function of the thyroid gland.
Types of Thyroid Nodules
This unusual lump in or on the thyroid gland at the front of the neck are usually caused by the abnormal overgrowth of cells in the gland. Either solid or filled with fluid, there are different types of thyroid nodules:
- Non cancerous Thyroid Nodules
- Toxic Nodules (Hyperthyroidism)
- Multinodular Goiter
- Thyroid Cysts
Thyroid Nodules Symptoms
Thyroid nodules do not commonly cause symptoms however, you’re likely to experience some of these symptoms when thyroid nodules begin to grow:
- Pain from nodule bleeding or inflammation
- Breathing and (or) swallowing difficulties
- Hoarseness
- Hyperthyroidism
- Weight gain or loss
- Heat intolerance
- Muscle weakness
Causes and Risk Factors
Thyroid nodules are of various forms and sizes, from small non-cancerous ones, hyperthyroidism, or large cysts . Most may not be serious, but it is best to receive an evaluation to assess the severity and nature of the thyroid nodule. While exact causes are unknown, nodules can grow due to following factors:
- Either iodine excess, deficiencies, thyroid autoimmunity
- Thyroid conditions such as hyperthyroidism
- Family history of thyroid nodules
How are Thyroid Nodules Diagnosed?
The main goals when assessing a thyroid nodule are to determine if it is cancerous and to check thyroid function. Normally, an ultrasound scan followed by fine needle biopsy (FNAC) is done to decide on nature of the thyroid nodules. Tests to help evaluate and diagnose a thyroid nodule may include:
Physical exam: Your doctor will assess the size and consistency of the nodule. You may need to swallow repeatedly while the provider examines your thyroid.
Thyroid function tests: A thyroid blood test checks the levels of thyroid hormones in your blood and whether your thyroid is functioning properly.
Ultrasound: A thyroid ultrasound will produce images of your thyroid gland. It will also provide more information about the shape and structure of the nodules.
Fine-needle biopsy: A very thin needle is used to remove a sample of cells from the nodules. The samples are then sent to the lab for evaluation to determine whether cancer is present.
Thyroid scan: A small amount of radioactive iodine is administered either through injection or orally. A special camera is then used to take pictures of your thyroid.
Thyroid Nodules Treatment Options
- Monitor with regular ultrasound scan and biopsy if required.
- Surgical resection of partial or whole thyroid gland
- Radiofrequency ablation of thyroid nodules
One of the latest techniques introduced for treating these patients is radiofrequency ablation (RFA) of thyroid nodules. This is a minimally invasive technique that involves introducing a small special needle under ultrasound guidance into the nodule. Heat energy is applied to the nodule using this needle with destruction of cells from within. The nodules gradually shrink in size on follow-up and become a scar tissue within the normal thyroid gland.
Thyroid Nodules RFA Treatment Advantages
The major advantages of the technique are as below.
- It is done as day surgery procedure under light sedation.
- It takes about 45 minutes to one hour to complete the entire procedure.
- Patients are discharged the same day.
- Normal thyroid tissue adjacent to the nodule is preserved.
- It does not affect thyroid function.
- Multiple nodules can be treated at same time.
- The treated nodules do not regrow again.
- No surgical scar with needle mark on the skin.
- Quick recovery and back to full activity and normal lifestyle.
- The technique is suitable to treat even large thyroid nodules.
Frequently Asked Questions
What are thyroid nodules?
Thyroid nodules are abnormal lumps or growths that develop within the thyroid gland in the neck. They may be solid or fluid-filled, and most thyroid nodules are benign (non-cancerous) and do not affect thyroid function.
Are thyroid nodules cancerous?
Most thyroid nodules are not cancerous. However, some nodules can be malignant, which is why proper evaluation is important. Doctors may use a thyroid ultrasound, thyroid function tests, and fine-needle aspiration biopsy (FNAC) to determine whether a nodule requires further treatment.
What are the symptoms of thyroid nodules?
Many thyroid nodules do not cause noticeable symptoms. Larger or symptomatic nodules may cause a lump or swelling in the neck, difficulty swallowing or breathing, neck pain, or hoarseness. Some nodules can also produce excess thyroid hormone, potentially causing symptoms such as weight changes, heat intolerance, and muscle weakness.
How are thyroid nodules diagnosed?
Thyroid nodules are typically evaluated with a physical examination, thyroid blood tests, and an ultrasound scan. If the ultrasound shows concerning features, a fine-needle aspiration biopsy (FNAC) may be recommended to examine cells from the nodule. In selected cases, a thyroid scan may also be performed.
Do all thyroid nodules need treatment?
No. Many thyroid nodules are small, benign, and do not cause symptoms, so they can be monitored with regular ultrasound examinations. Treatment may be considered when a nodule is large, symptomatic, growing, producing excess thyroid hormone, or has other concerning features.
What is radiofrequency ablation (RFA) for thyroid nodules?
Radiofrequency ablation (RFA) is a minimally invasive treatment that uses a specialized needle under ultrasound guidance to deliver heat energy into a thyroid nodule. The treatment destroys the targeted nodule tissue, which gradually shrinks over time while preserving surrounding healthy thyroid tissue.
What are the benefits of thyroid nodule RFA?
Thyroid nodule RFA is a minimally invasive procedure that can generally be performed as day surgery under light sedation. It can help reduce the size of suitable nodules while preserving normal thyroid tissue and thyroid function. It also avoids a traditional surgical incision and may allow patients to return to normal activities quickly.
How long does thyroid nodule RFA take, and what is recovery like?
Thyroid nodule RFA typically takes about 45 minutes to one hour, depending on the nodule and treatment required. Patients can generally go home the same day. Because RFA does not require traditional thyroid surgery, recovery is usually quicker and there is no conventional surgical scar.
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