Can thyroid nodules be treated?

Written by Luo Juan
Endocrinology
Updated on December 30, 2024
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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 55sec home-news-image

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 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.

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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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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.