"Malignant thyroid nodules" means what?

Written by Zhang Jun Jun
Endocrinology
Updated on November 23, 2024
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Thyroid nodules are assessed under ultrasound with a grading system, and if rated at level three or higher, they tend to be more likely to be malignant. The most common malignancy in thyroid nodules is thyroid cancer. Among all types of tumors, thyroid cancer tends to grow slowly and is relatively less malignant. Therefore, if an ultrasound suggests a high likelihood of malignancy in a thyroid nodule, further examinations should be conducted. This can include a fine needle aspiration biopsy, thyroid contrast-enhanced ultrasound, or even direct surgical removal of the malignant nodule for further pathological examination to determine whether it is benign or malignant. Since the degree of malignancy of thyroid nodules is relatively low compared to other malignant tumors, a high grading score on a thyroid nodule should not be overly worrying. It is advisable to proceed with formal medical checks and regular follow-ups, as the five-year survival rate is quite high, exceeding 80%.

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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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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.

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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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Diet for thyroid nodules calcification

Patients with calcified thyroid nodules need to be cautious about their diet. Firstly, they should avoid irritating foods such as chili peppers, ginger, garlic, strong tea, coffee, and alcohol. Secondly, they should not consume foods high in fiber as these can cause diarrhea. Instead, they should eat foods rich in carbohydrates and fats, which provide energy and reduce the consumption of proteins in the body, as proteins play an important role in physiological regulation. Additionally, these patients should consume foods rich in vitamins and minerals to aid physiological metabolism. Lastly, it is beneficial for patients with calcified thyroid nodules to include animal organs in their diet.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Symptoms of thyroid nodules

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.