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 Luo Juan
Endocrinology
1min 9sec home-news-image

Can thyroid nodules be treated?

It depends on the situation. For some patients, we can evaluate whether thyroid nodules are accompanied by changes in thyroid function. If there is an overactive thyroid, antithyroid treatment is necessary. If there is underactive thyroid function, appropriate thyroid hormone supplementation is needed, and some patients' nodules can shrink. Additionally, for some thyroid nodules, if there are no accompanying changes in thyroid function, and the nodules are assessed as benign through ultrasound and other evaluations, no special treatment is generally needed. It is recommended to monitor thyroid ultrasound and function every six months to a year. Furthermore, if some thyroid nodules grow rapidly or there is a potential for cancerous changes, or if there are significant compressive symptoms, we can also perform a fine needle aspiration biopsy of the thyroid cells, or surgical treatment. Therefore, whether thyroid nodules can be treated also depends on the situation.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
1min 14sec home-news-image

Do thyroid nodules affect pregnancy?

This decision should be based on the nature of the thyroid nodules. If the thyroid nodule is benign, pregnancy generally will not be affected, and it is possible to conceive. However, if the patient has malignant thyroid nodules, I would advise against rushing into pregnancy. Firstly, prioritize treating the malignant thyroid nodules promptly. If you become pregnant during this time, the risks associated with surgery and medications for both the pregnant mother and the fetus are very high. Nevertheless, after receiving timely and standardized treatment and once the patient's condition has stabilized, it is possible to conceive. However, it should be noted that surgery may lead to reduced thyroid function. In the first 12 weeks of pregnancy, the fetus relies on the mother for thyroid hormone supply. If the mother's thyroid hormone levels are too low, it can lead to delayed fetal development, and even abnormal brain development, resulting in a baby born with intellectual disabilities. Therefore, women with a history of thyroid disease should develop a treatment plan under the joint collaboration of an endocrinologist and an obstetrician-gynecologist.

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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 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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How to treat thyroid nodules?

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.