Symptoms of thyroid nodules

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 27, 2024
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Thyroid nodules in the early stages often show no clear symptoms, with only small nodules appearing within the body. The size of these nodules can range from several millimeters to several centimeters, and their texture is generally slightly harder compared to the surrounding glandular tissue. When the enlargement is more noticeable, the nodule can move up and down with the thyroid gland during swallowing. In addition to the presence of nodules, when the thyroid nodule is prominent, it can compress the trachea, leading to difficulty breathing and irritative dry cough. If it compresses the recurrent laryngeal nerve, it may cause hoarseness, varying degrees of hoarseness, and even an inability to speak loudly. In patients with malignant nodules, the invasive malignant cells can cause symptoms such as hoarseness, difficulty breathing, dysphagia (difficulty swallowing), diarrhea, palpitations, facial flushing, and decreased blood calcium levels. If these symptoms occur, it is crucial to seek medical attention promptly.

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Written by Li Jin Quan
General Surgery
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How to treat thyroid nodules calcification.

The treatment of thyroid nodule calcification in clinical practice is based on the size of the calcification lesions. Because large calcified thyroid nodules have a very small possibility of malignancy, the routine clinical approach is to continue observation and perform cytological examination through thyroid fine-needle aspiration. For small calcified thyroid nodules, which have a higher likelihood of malignancy, active surgical treatment is usually adopted. During surgery, the next steps of the treatment plan are determined based on the pathological findings.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Effects after thyroid nodule removal

Thyroid surgery often leads to postoperative bleeding as a common complication. Bleeding may compress the trachea, causing difficulty in breathing. If a patient exhibits severe breathing difficulties along with significant bleeding from the drainage tube post-surgery, emergency hemostasis should be performed. Secondly, tracheomalacia. Long-term compression from the mass softens the tracheal wall, leading to a collapse due to inadequate support from surrounding tissues. Thus, after removing thyroid nodules, the thyroid and adjacent tissues fail to support the softened trachea, resulting in breathing difficulties. Thirdly, pharyngeal edema. During surgery, inflammatory stimulation can cause edema in the surrounding tissues, which may lead to difficulty in breathing. Therefore, after ruling out possibilities of postoperative bleeding, tracheomalacia, or vocal cord paralysis, pharyngeal edema should be considered. Nebulization therapy can be administered. Fourthly, vocal cord paralysis is common due to accidental damage to the recurrent laryngeal nerve during surgery, causing hoarseness. Generally, patients may gradually recover over three to six months, and symptoms can improve. The fifth effect is damage to the parathyroid glands. If the parathyroid glands are damaged, it may lead to abnormal blood calcium levels and symptoms of hypocalcemia, such as tetany and spasms. Most cases are due to vascular damage to the parathyroid glands resulting in temporary hypofunction, which often recovers shortly. The sixth possible outcome is a thyroid storm. Some patients with hyperthyroidism may experience a sudden release of large amounts of thyroid hormone into the bloodstream post-surgery, causing high fever, irregular heart rate, restlessness, nausea, vomiting, coma, and even death. The seventh effect is that removal of the thyroid gland leads to a deficiency in thyroid hormones, resulting in symptoms of hypothyroidism.

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Written by Yuan Qing
Pulmonology
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Which is more serious, pulmonary nodules or thyroid nodules?

It is impossible to compare the severity between thyroid nodules and lung nodules. Firstly, thyroid nodules and lung nodules occur in different organs. Lung nodules are mostly caused by inhalation of dust, pollutants, or smoke. Thyroid nodules, on the other hand, often result from genetic factors, or issues with the patient’s own constitution leading to the formation of these nodules. Most lung nodules can be classified as benign or malignant through diagnostic tests, whereas it is often difficult to assess the nature of thyroid nodules with standard tests. Additional auxiliary examinations, such as PET-CT or SPECT, and biopsy pathology are needed to determine the nature of thyroid nodules. Therefore, the approaches to observing and handling these two types of nodules are entirely different, and they cannot be compared.

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Written by Li Jin Quan
General Surgery
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Is thyroid nodule calcification scary?

Thyroid nodule calcification is a common disease of the human thyroid gland. When seeing thyroid nodule calcification, we should not be afraid. Thyroid nodule calcification refers to the dense proliferation of thyroid cells, which, during an ultrasound examination, appears as strong spots, specks, or rings on the thyroid. Thyroid nodule calcification can be divided into coarse calcification and microcalcification. Generally, coarse calcification is benign, and we can continue to observe it. If it is microcalcification, we can conduct a pathological examination. If it is malignant, surgical treatment can be performed; if it is benign, we can continue to observe. Therefore, thyroid nodule calcification is not something to be afraid of.

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Written by Li Jin Quan
General Surgery
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How to deal with calcification of thyroid nodules?

Thyroid nodules calcification can be divided into coarse calcification and microcalcification. Coarse calcification is generally benign, and benign conditions do not require special treatment. When a large nodule causes compression symptoms and affects our appearance, surgical removal can be considered. Microcalcification is mostly likely to become malignant, therefore, cytological biopsy of the thyroid should be performed. If it is benign, we can continue to observe it. If it is malignant, we can treat it with surgery, comprehensive therapy, or radiotherapy.