Probability of thyroid nodules becoming cancerous

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 16, 2024
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The malignant manifestation of thyroid nodules is thyroid cancer. Thus, thyroid nodules are divided into two major categories: benign and malignant. Benign nodules generally make up the vast majority, with malignancies accounting for less than 5%. Malignant thyroid nodules are cancerous. Some benign thyroid nodules may also become malignant over time. Generally, small nodules do not show obvious clinical symptoms during the cancerous transformation, but their nature changes. When a nodule compresses surrounding tissues and causes certain symptoms, such as hoarseness, tracheal compression, and difficulty swallowing, it often indicates that the tumor is in the middle or late stage. Overall, the chances of benign nodules becoming cancerous are very small. The malignancy rate of benign nodular goiter is about 5%, and the possibility of adenomas turning malignant is around 10%. As the diameter increases, the possibility of adenomas becoming malignant gradually increases. There are several high-risk factors for the malignant transformation of thyroid nodules: for instance, having a history of radiation exposure to the head and neck area during childhood or adolescence, patients who are younger than 14 or older than 70; the rate of malignant transformation of thyroid nodules significantly increases; and the rate of malignant transformation in male nodules is significantly higher than in females. Also, patients whose nodules significantly increase in size in a short period during regular check-ups are also considered high-risk for malignancy.

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Written by Lin Xiang Dong
Endocrinology
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Where to do acupuncture for thyroid nodules?

Thyroid nodules do not require acupuncture treatment. The vast majority of thyroid nodules are benign, with only a small portion, about 5%, being malignant. We generally determine the treatment approach based on whether the nodule is benign or malignant. For benign nodules, we typically follow up with observation, while malignant nodules require surgical treatment and oral medication, or Iodine-131 radiotherapy. The primary evaluation for distinguishing between benign and malignant nodules relies on the results of color Doppler ultrasound and the pathology results from thyroid fine-needle aspiration.

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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 Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid Nodule Classification Standard

To standardize the diagnosis of thyroid diseases, we have categorized thyroid nodules into six levels, with the severity and the likelihood of malignancy increasing with each level: Grade 1 refers to normal thyroid tissue; Grade 2 indicates benign changes in the thyroid, with the risk of malignancy increasing over time. For example, simple thyroid cysts, which require an ultrasound check every 1-2 years; Grade 3 refers to the presence of nodules in the thyroid with a malignancy possibility of

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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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Is thyroid nodule ablation a good treatment?

Thyroid nodule ablation has its advantages over traditional surgery, but it also has its shortcomings. The advantages include minimal trauma, less bleeding, and less pain for the patient. Ablation involves inserting an ablation needle through the skin of the patient's neck, directly into the tumor to perform the ablation with the goal of eliminating the nodule. Since it does not require cutting, it reduces damage to surrounding tissues and bleeding, allowing the patient to resume activities earlier and reduce suffering. However, the drawback is that ablation is effective for smaller benign thyroid masses, but for complex or malignant thyroid nodules, the treatment effectiveness is poor, and its use is not advocated.