Thyroid nodules – causes, symptoms, treatment methods. Thyroid nodules and cancer

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They are usually detected during a medical examination and an ultrasound (ultrasound) of the thyroid gland or neck, most often in women. All thyroid nodules require observation and some also need to be treated. Fortunately, only a few percent of them turn out to be malignant tumors.

Thyroid nodules – causes

The thyroid gland is an organ responsible for metabolism. Thanks to it, hormones such as calocytonin, thyroxine and triiodothyronine are secreted. Thyroid nodules, also called nodular goitre, are a symptom of an enlarged thyroid gland. You can detect them yourself with your fingers or ask your doctor to do a palpation. Thyroid nodules are an endocrine disease that occurs in 10-40% of people. patients, mainly women.

There are various reasons for the formation of nodules within the thyroid gland. Most endocrinologists say the main cause of the condition is iodine deficiency, without which the thyroid gland cannot function properly. When the deficiency of the element in the diet is long-term, the thyroid does not receive the right amount of it, and this leads to an increase in the concentration of thyroid-stimulating hormone by the pituitary gland and the formation of nodules.

Thyroid nodules can appear in both larger and smaller clusters – sometimes there are many of them, and sometimes they are single. There are two types of thyroid nodules – solid nodules (filling the cells) and cysts (fluid-filled thyroid lesions). In addition to iodine deficiency, the formation of thyroid nodules may be influenced by autoimmune diseases leading to thyroiditis, e.g. Hashimoto’s disease.

The disease is more common in women because they are more prone to thyroid problems – this is due to the fact that they undergo intense hormonal changes during puberty, pregnancy, breastfeeding and menopause. Each of the above-mentioned changes may cause hyperthyroidism or hypothyroidism. However, it is worth adding that the specific causes of thyroid nodules have not yet been established.

Using scintigraphy can diagnose whether a single autonomic thyroid nodule is causing hyperfunction. Thanks to the examination, it is also possible to supplement the diagnosis of toxic nodular goiter with an accurate assessment of the isotope distribution. The scintigraphy method also allows you to determine what type of thyroid nodule you are dealing with. In nuclear medicine they are described as “warm” nodules (they absorb an isotope like normal thyroid tissue); “cold” nodules (do not capture the isotope); “hot” nodules (they capture the isotope more than the rest of the flesh).

Read also: What will help an overworked thyroid gland?

Symptoms of thyroid nodules

The presence of thyroid nodules may be difficult to detect initially, as there are sometimes no clinical symptoms in the early stages. However, after some time they become visible, because the anatomical space of the thyroid area is small and there is pressure as the nodules develop. Thyroid nodules occur on the front side of the neck and you can feel them with your hand as the neck is enlarged in this area.

Many women become aware of thyroid lumps when swallowing – the neck is then tense, which helps detect a lump. However, in some cases the nodules are so small that sometimes they do not cause symptoms visible to the naked eye and the patient finds out about their presence, for example, during a routine ultrasound of the thyroid gland. In other cases, the tumors are large enough to make breathing difficult and cause difficulty swallowing and hoarseness.

The abnormality in the work of the thyroid gland can be precisely determined only through laboratory tests. When it turns out that a given patient has deviations from the diagnostic norms, it is an indication to continue the diagnosis. It is worth adding that there are cases of people who have nodules on the thyroid gland and hormones are normal.

Read more about it: Symptoms of thyroid disease

Diagnosis of thyroid nodules

The first symptoms that suggest the presence of thyroid nodules are throat tightness, difficulty swallowing, and chronic coughing. Their size and the consistency of the altered tissue can be assessed by touch. Anyone who notices such changes in the neck area (the gland is located there) should consult a family doctor, who will order a blood test to determine whether TSH (the hormone responsible for stimulating the thyroid gland) is secreted in the right concentration.

The diagnosis of thyroid nodules is advisable, although not every nodule should be treated. However, it is worth deciding to perform diagnostic tests and, based on the obtained result, decide which treatment method to use. Treatment of thyroid nodules, regardless of the type of therapy, is to reduce the size of the thyroid gland and the nodules in it.

Make an appointment for a thyroid surgery consultation today. You can find a specialist in your area on the website clinics.pl.

Treatment of thyroid nodules

How to treat thyroid nodules depends on the individual case. The method is selected by the doctor and adapted to the individual clinical situation. One of them is observation, which lasts from 1 to 2 years. Observation is to control the size of the nodules. After 6 months, the patient should undergo a check-up and ultrasound examination every 6-12 months. If they show that the changes are increasing, then the doctor extends the diagnostic activities.

Thyroid lumps can be treated with hormones. Thanks to the procedure, the level of thyroid hormones is balanced to prepare the patient for gland surgery. Hypothyroidism is treated by hormone replacement with levothyroxine. Lumps can also be removed surgically. Great effectiveness in treating cysts is achieved by injecting ethanol into them – this is the method used to treat individual nodules.

It is becoming more and more popular every year treatment of thyroid nodules with microsurgical ablation techniques. The method is more and more widely available and gaining more recognition – it is mainly used in the treatment of benign, large and single nodules. According to specialists, the risk of complications is small. During the treatment with the ablative technique, it is possible to use, for example, an echolaser, i.e. an infrared laser with ultrasound imaging.

Thyroid nodules are also removed using radioiodine, a radioactive element. The thyroid gland catches it, which causes it to begin to be destroyed. According to specialists, this is one of the safer methods, although the treatment of neutral nodules in this way requires the use of a large dose of the element and the temporary isolation of the patient after the procedure. What’s more, after the procedure, the patient will have to take thyroid hormones on a permanent basis.

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Also check: What does the thyroid gland suffer from?

Treatment of thyroid nodules and age

The prognosis of differentiated thyroid carcinomas is much better in younger patients. Papillary cancer has the best prognosis and is fully curable in the microcarcinoma stage. The basic method of treating thyroid neoplasms is its total excision with the lymph nodes in the neck. A smaller range of surgery is reserved only for a very small (less than 1 cm) tumor of papillary cancer.

Fine-needle aspiration biopsy is the basic test to recognize or suspect a malignant change in a thyroid tumor. It also makes it possible to refer patients suspected of having a malignant lesion to surgical treatment. Thanks to this study, the number of unnecessary goiter operations has decreased and the cancer detection rate has increased.

How is the operation of thyroid nodules performed with echolaser?

During the procedure, the doctor uses needles to insert optical fibers into the tumor and transmit energy from the laser source. As a result, heat is generated, which destroys the tumor tissue and leads to tissue destruction – as a result, the nodules die. The surgeon monitors the entire operation on an ongoing basis and thanks to the ultrasound image he can precisely operate the laser light without damaging the tissues next to the tumor.

Removal of thyroid nodules with a laser takes about 30 minutes. However, the duration of the procedure depends on the number of nodules. The operation is usually performed without anesthesia (neither general nor local). The patient’s skin remains untouched and does not need to be incised – this makes the procedure comfortable. However, it is worth adding that it is possible to use local anesthesia.

Thyroid nodules and cancer

The presence of thyroid nodules does not necessarily imply that a person already has or will soon develop cancer. Many nodules are benign changes – according to specialists, only a few percent of thyroid nodules are malignant. However, in order to determine whether a given patient is suspected of having a cancer, an ultrasound examination should be performed – the presence of hypoechoic nodules may be of concern.

Thanks to the ultrasound examination, you can also notice changes that indicate a low risk of malignant neoplasm – these include, among others, cysts and small nodular hyperplasia of the thyroid gland. In addition to the hypoechoic nodules mentioned above, the reasons for concern are also the compact consistency of the nodule, its rapid enlargement and irradiation. To determine whether we are dealing with a malignant process, a thyroid biopsy should be performed.

Thyroid nodules are sometimes heralds of malignant neoplasms, which are the most serious thyroid proliferative diseases. The most common disease is thyroid cancer, which mainly develops from cells of the alveolar epithelium or paralveolar cells. Malignant neoplasms develop rarely, and thyroid nodules occur in every 10th woman – about 5% of thyroid nodules are the aforementioned thyroid cancer.

Among neoplasms, there are differentiated neoplasms (papillary and follicular carcinoma), which constitute 90%. thyroid cancer. The worst prognosis is undifferentiated cancer, constituting from 2 to 5 percent. thyroid cancer. There is also medullary thyroid cancer, which accounts for about 5 percent. cancer and lymphoma, a rare malignant tumor that occurs in people with chronic thyroiditis.

Generally, thyroid cancer does not affect the function of the thyroid gland. The factor predisposing to its development is the external irradiation of the neck with ionizing rays and the presence of the disease in family members. Iodine deficiency plays an important role in the development of follicular thyroid cancer. The development of papillary cancer is fostered by the consumption of excessive amounts of iodine.

Find out more: Thyroid neoplasms – types, causes, symptoms, diagnosis. Treatment of thyroid cancer

Can thyroid nodules go away?

Typically, thyroid nodules do not require treatment but only regular monitoring. There are many cases where a doctor has found that a thyroid nodule has shrunken, but the reason was, for example, a mistake in a previous test – sometimes a thyroid nodule may be mistaken for a cyst or a dilated blood vessel. According to some endocrinologists, the likelihood that a small lump will be absorbed is rather small.

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