Diagnosis and Management of Thyroid Nodules

 



Q1. What are thyroid nodules?
Thyroid nodules are common condition referring to the lumps in the thyroid gland, an organ at the front and lower part of the neck. These nodules can be either benign or malignant. While most of them are benign, around 5% to 10% can be malignant. Common symptoms include visible lumps in the neck, followed by swallowing and breathing difficulties. Nevertheless, in most cases, patients only suffer from small lumps and may not complain of any symptoms.
 
Q2. What are the causes of thyroid nodules?
While the cause of thyroid nodules is not certain, factors such as iodine deficiency, history of thyroid inflammation or genetic conditions may increase the likelihood of developing the nodules. In most patients, no particular cause of the condition is present. The thyroid is a cyclical organ responsible for secretion of thyroid hormones. The organ’s size changes from time to time, thus increasing the chance of developing thyroid nodules. Thyroid nodules are more common in women, and the risk increases with age.
 
Q3. How are thyroid nodules diagnosed?
To diagnose a thyroid nodule, the doctor will first review the patient's medical history, and perform physical examination and arrange for diagnostic tests. Most patients usually complain of lumps in the neck. The doctor will then assess whether the lump is originating from the thyroid during examination. Afterwards, an ultrasound of the neck will be performed to determine if the lumps are originating from the thyroid gland. When in doubt, a biopsy of the thyroid lump would be undergone to obtain some thyroid tissue for diagnosis. Thyroid nodules can be benign or malignant, and very few cases are cancerous. For benign thyroid nodules, most cases can be managed conservatively by observation.
 
Q4. What is the treatment of thyroid nodules?
Most thyroid nodules are benign. Only 5% to 10% are malignant. For malignant cases that require treatment, either part of or the entire thyroid is removed. For benign cases, treatment will depend on how the nodules affect the patients. If there is a visible lump or one feels unwell, treatment may be necessary. Treatment can involve surgical removal of part of or the entire thyroid. New minimally invasive technique such as thyroid radiofrequency ablation is suitable for patients with small and benign thyroid nodules. This option offers advantages that include absence of external wound and reduction of the size of nodules by 50% to 75%.

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