Thyroid Goiter and Nodules 101: What you need to Know.

Thyroid Goiter and Nodules 101: What you need to Know.

1. A swelling in the neck due to an enlarged thyroid gland is called a goiter.
2. Worldwide, the most common cause of thyroid goiter is iodine deficiency.
3. However, this is becoming a rarer cause because iodine is now present in drinking water and some of the foods we eat, such as iodized table salt.
4. Hashimotos thyroiditis and Graves’ disease, two autoimmune diseases, are much more common causes of goiter in the western world.
5. Nodules are lumps in the thyroid gland. Thyroid nodular goiter is common and occur in 50 per cent of adults.
6. Most nodules don’t cause any signs or symptoms.
7. Some nodules can become so large that they can be felt or seen, or can press on the windpipe or esophagus, causing shortness of breath or difficulty swallowing.
8. In some cases, thyroid nodules produce additional thyroxine — a hormone secreted by the thyroid gland.
9. The extra thyroxine can cause symptoms of hyperthyroidism called toxic nodular goiter.
10. Graves’s disease causes a goiter and hyperthyroidism.
11.  Symptoms are unexplained weight loss; Intolerance to heat, Tremor,Nervousness; and Rapid or irregular heartbeat.
12. A few thyroid nodules (5 per cent) are cancerous, but determining which nodules are malignant can’t be done by symptoms alone.
13. Risk factors for thyroid carcinoma include age of less than 20 years or more than 60 years, a history of neck irradiation and a family history of thyroid cancer.
14. The imaging modality of choice for the investigation of thyroid nodules is high-resolution ultrasound.
15. The patient’s family physician will therefore refer patients to an endocrinologist for evaluation and ultrasound assessment of an enlarged thyroid gland.
16. The is to determine which thyroid nodules are suspicious in appearance and need to undergo a biopsy procedure called Fine Needle Aspiration Cytology (FNAC) to check for cancerous cells.
17. The ultrasound features suggestive of malignancy are as follows: CALCIFICATIONS, Microcalcifications,LOCAL INVASION AND LYMPH NODE METASTASIS, Direct tumour invasion of adjacent soft tissue and mets to lymph nodes are very specific signs of thyroid malignancy.
18. Abnormal appearing lymph nodes on the same side as the thyroid tumor should arouse suspicions of metastasis.
19. After identifying a suspicious nodule, the endocrinologist will then perform an ultrasound-guided fine needle aspiration to retrieve cells, which are then examined by a cytologist.
20. Collection of DNA/RNA markers during the biopsy can help decide if surgery is needed.
21. If a diagnosis of thyroid cancer is made, the endocrine neck certified endocrinologists will do a complete VII level neck lymph node evaluation looking for suspicious cancer lymph nodes to biopsy before the surgery. This last test can change the original surgery to include a modified neck dissection and total thyroidectomy.

If you have a goiter you need to have an evaluation.

Call me at 310-393-8860 or thyroid.manager@protonmail.com.

Dr.G.