Differences between the symptoms of thyroiditis and thyroid cancer

Written by Zhao Xin Lan
Endocrinology
Updated on September 24, 2024
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Thyroiditis, if it is acute suppurative thyroiditis, clinical manifestations include fever, local pain in the thyroid, tenderness on palpation, and a hard texture of the thyroid. Examination will show an increase in white blood cells. Subacute thyroiditis may also present with mild fever or high fever and local pain in the thyroid, but compared to suppurative thyroiditis, the increase in white blood cell levels is not as significant in subacute thyroiditis. If it is autoimmune thyroiditis, there may not be obvious symptoms clinically; there may be enlargement of the thyroid, and the thyroid may feel tougher upon palpation. As for thyroid cancer, clinically, if it does not cause hyperthyroidism or hypothyroidism, there are no specific symptoms. When the cancerous tumor is large, there may be an enlargement of the thyroid, the texture of the enlarged thyroid will be very hard, and there will be notable local adhesions. Of course, the main difference can be detected and diagnosed through an ultrasound examination.

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Is thyroid swelling malignancy the same as thyroid cancer?

Thyroid malignancy refers to thyroid cancer, but even malignant thyroid cancer generally has a good prognosis. However, it is crucial to achieve early detection, diagnosis, and treatment. It is advised to promptly visit a thyroid specialty department for comprehensive examinations, including thyroid ultrasound, evaluation of thyroid function, and related thyroid antibodies. A fine needle aspiration biopsy should be conducted for a clear pathological diagnosis, followed by immediate active treatment, primarily surgical. Thyroid cancer includes papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and undifferentiated cancer. The surgery mainly involves minimally invasive and traditional methods. Post-surgery, it is recommended to perform lymph node dissection, assess the extent of metastasis, and decide whether to proceed with Iodine-131 radiotherapy. Due to the loss of thyroid function, proactive thyroid hormone replacement therapy is advised, along with dynamic monitoring of thyroid health through ultrasound and related examinations.

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Is a hypoechoic area definitely thyroid cancer?

A thyroid nodule underwent an ultrasound B-examination and showed hypoechoic features, but this does not necessarily indicate thyroid cancer. It is essential to conduct relevant tests to determine the cause. For such thyroid nodules, it is first important to check their specific size. If there is concern about the presence of a malignant tumor, it is advisable to perform a fine needle aspiration for pathological examination to confirm the diagnosis. If the thyroid nodule exceeds one centimeter and causes local pain or affects surrounding blood vessels, leading to symptoms of compression, it is recommended that patients should promptly undergo surgical removal for treatment.

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Thyroid cancer ultrasound manifestations

The characteristics of ultrasonography for thyroid cancer include the tumor being a solid hypoechoic mass with unclear boundaries, uneven internal echoes, abundant internal blood flow, and the presence of sandy calcifications and longitudinal growth, among others. Currently, ultrasonography is the preferred method for examining thyroid nodules. It can clearly identify the number, nature, and location of thyroid nodules, as well as whether there are any abnormally enlarged lymph nodes in the neck. Ultrasonography is highly accurate in differentiating the nature of thyroid nodules, with experienced ultrasonographers reaching an accuracy rate of over 80%. However, the highest accuracy in differentiating the nature of thyroid nodules is still achieved with fine-needle aspiration cytology.

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How is thyroid cancer diagnosed?

The first point is the diagnostic process for differentiated thyroid cancer. Initially, most patients may not have symptoms, while a minority might show symptoms due to invasion of surrounding organs. Ultrasound examination is the preferred method for diagnosing thyroid nodules. Ultrasound can clarify the number, nature, and location of thyroid nodules, as well as provide information on whether there are abnormally enlarged lymph nodes in the neck. It has a relatively high accuracy in identifying the nature of thyroid nodules. Currently, the most accurate test for determining the nature of thyroid nodules remains the fine needle aspiration cytology, which has a diagnostic sensitivity of 83-92% and specificity of 80-92%, but it is not 100% conclusive. The second point is about the diagnosis of medullary thyroid cancer. Besides the tests common for thyroid cancers, additional tests for medullary thyroid cancer can include fine needle aspiration, ultrasound, and some serological tests, such as calcitonin and carcinoembryonic antigen tests.

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Early symptoms of thyroid cancer

Differentiated thyroid cancer often has no symptoms in the early stages, with only incidental palpation of nodules of various sizes and textures on the front of the neck. Some patients may find abnormalities during routine physical examinations through imaging studies, and symptoms may appear only in the later stages. The second point concerns the characteristics of medullary thyroid cancer, which exhibits specific symptoms early on, such as persistent, watery diarrhea. Additionally, this cancer involves an endocrine syndrome, where tumor cells secrete calcitonin and adrenocorticotropic hormone, potentially leading to facial flushing, elevated blood pressure, and reduced blood calcium. This may be associated with other conditions such as pheochromocytoma, multiple mucosal neuromas, and parathyroid adenomas, which can also cause corresponding symptoms.