How to treat thyroid nodules?

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 03, 2024
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Clinically, if a thyroid nodule is confirmed to be a benign tumor, generally speaking, if thyroid function is normal and the nodule is not large, urgent treatment is not necessary, and regular follow-up is sufficient. If the thyroid nodule significantly enlarges, causing compression of the trachea or nerves, surgery should be considered. Furthermore, for ectopic growth of thyroid tissue behind the sternum, surgical removal is also considered necessary. Another scenario that requires special mention is if a thyroid nodule grows rapidly in a short period and ultrasound suggests calcification or bleeding within the cyst, thyroid cancer should be suspected. In this case, it's advisable to have the nodule surgically removed.

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Written by Zhang Peng
General Surgery
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Thyroid nodule surgery risks

The hazards of thyroid surgery actually refer to the risks involved in thyroid surgery. Thyroid surgery is now a common treatment method. The main risks of thyroid surgery include anesthesia on one hand, and postoperative bleeding on the other. There might be a need for a second incision for decompression. The most common complications are choking while drinking water and hoarseness of voice, mainly due to the involvement or damage to relevant nerves during the surgery. Generally, these complications resolve after a period of adjustment, and most people can recover normally.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid nodule examination checks what

Generally, when thyroid nodules are detected, one should visit the hospital's breast and thyroid surgery department or the endocrinology department. If you find a thyroid nodule, you can consult a doctor and undergo some relevant tests based on your specific situation. Typically, the following tests are conducted: 1. Thyroid ultrasound: This can determine the size, number, location, texture, shape, and edges of the nodules, including whether there is calcification. It also examines the blood supply within the thyroid nodule, the relationship with surrounding tissues, and assesses whether there are lymph nodes in the neck and the nature of these lymph nodes. 2. Blood tests are needed to measure thyroid function, particularly the level of Thyroid Stimulating Hormone (TSH). Higher levels of TSH indicate that the thyroid nodule is more likely to be proliferative, and thus, the risk of thyroid cancer increases. In addition, Thyroglobulin (Tg) can be measured. Another measure is Serum Calcitonin (Ct). If serum calcitonin is > 100 pg/mL, medullary thyroid cancer should be highly considered, as these cancer cells can secrete large amounts of serum calcitonin, causing this marker to significantly increase. Nuclear isotope imaging is also performed. If the nodule is large and TSH levels are low, a thyroid radionuclide scan is conducted to see if the nodule is a hyperfunctioning adenoma. When necessary, a Fine Needle Aspiration Biopsy (FNAB) is also performed. Fine needle aspiration is an invasive test, but it is currently an important and most efficient method to assess the benign or malignant nature of the nodule. It is generally performed under ultrasound guidance.

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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 Hu Jian Zhuo
Nephrology and Endocrinology
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Are thyroid nodules serious?

The severity of thyroid nodules needs to be assessed based on their nature, size, function, and location. Generally, they can be classified into benign and malignant, with malignant nodules being thyroid cancer, which requires timely treatment. Surgical treatment is the main method for treating thyroid cancer, whereas most benign nodules do not require special handling. Regarding the size of the thyroid nodules, if the nodules are too large and compress surrounding tissues such as the trachea, esophagus, and nerves, surgical treatment is recommended. For common benign nodules, regular observation is sufficient. Functionally, some thyroid nodules may affect thyroid function, such as in Hashimoto's thyroiditis, which can present with diffuse multiple nodules, leading to either hyperthyroidism or hypothyroidism. In such cases, appropriate medication treatment is needed. From a positional perspective, ectopic growth of thyroid nodules, if located at areas like the base of the ear, pharynx, neck, esophagus, or thoracic cavity, is a rare congenital developmental anomaly. If such a nodule significantly enlarges and compresses surrounding tissues, surgical treatment is advised.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Do thyroid nodules require surgery?

Whether thyroid nodules require treatment generally depends on medical guidelines. Thyroid nodules larger than 1cm with malignant features typically require biopsy. The decision for a biopsy should be made by a professional ultrasonographer after examination. Therefore, upon detecting a nodule, it is crucial to visit a specialized hospital for further ultrasound examination. If the nodule is malignant, we recommend surgical removal. If it is benign, close observation is advisable. However, treatment is necessary under the following conditions: First, if the nodule is too large and compresses other organs, causing breathing difficulties, localized swelling, pain, or other discomforts. Second, if the nodule grows quickly, increasing in volume by more than 50% within six months, the possibility of malignancy should be considered and treatment is needed. Third, if the thyroid nodule is located behind the sternum, which is called an ectopic thyroid nodule, surgical treatment is necessary. If the thyroid nodule is large enough to affect the aesthetics of the neck, surgical treatment may also be considered.