Thyroid Goiters With Nodules 101:
A swelling in the neck due to an enlarged thyroid gland is called a goiter. Worldwide, the most common cause of thyroid goiter is iodine deficiency.
However, this is becoming a rarer cause because iodine is now present in drinking water and some of the foods we eat, such as table salt. Hashimotos thyroiditis and Graves’ disease, two autoimmune diseases, are much more common causes of goiter in the western world.
- Nodules are lumps in the thyroid gland.
- Thyroid nodules are common and occur in 50 per cent of adults.
- Most nodules don’t cause any signs or symptoms.
- 4.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.
- In some cases, thyroid nodules produce additional thyroxine — a hormone secreted by the thyroid gland. The extra thyroxine can cause symptoms of hyperthyroidism.
- A few thyroid nodules ( 4 per cent) are cancerous, but determining which nodules are malignant can’t be done by symptoms alone.
- 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.
- The imaging modality of choice for the investigation of thyroid nodules is high-resolution ultrasound. Seek out an endocrine certified endocrinologist to do the ultrasound and consultation before going to surgery.
- Do not have a thyroid ultrasound without an indication. Screening thyroid ultrasounds are dangerous as it leads to biopsies and even unnecessary surgeries.
- LOCAL INVASION AND LYMPH NODE METASTASIS
- Hypoechogenicity Very dark (hypoechoic) nodules are more likely to be cancerous.
- The patient with an indication can have a thyroid ultrasound and a thyroid biopsy if there are changes on the ultrasound that are worrisome.
- Spongiform nodules are not an indication to do a biopsy as they are benign.