Thyroid Nodules

Thyroid nodules are solid or fluid-filled lumps that form within your thyroid and are actually quite common. By the age of 60, half of all people have them. They’re often very small. You might only learn you have a thyroid nodule when your doctor feels for one during an examination or if you have an ultrasound of your thyroid.

Any time a thyroid nodule is detected, physicians must rule out cancer. About 95% of the time, thyroid nodules are non-cancerous, or benign.

Benign nodules include goiter (enlarged thyroid), benign follicular adenomas (benign thyroid tumor) and thyroid cysts (small, fluid-filled areas).

Symptoms and Diagnosis

Most thyroid nodules don’t cause signs or symptoms. But occasionally some nodules become so large that they can:

• Be felt or seen, often as a swelling at the base of your neck.
• Press on your windpipe or esophagus, causing shortness of breath or difficulty swallowing

In some cases, thyroid nodules produce additional thyroxine, a hormone secreted by your thyroid gland. The extra thyroxine can cause symptoms of hyperthyroidism, such as:

• Unexplained weight loss
• Increased sweating
• Tremor
• Nervousness
• Rapid or irregular heartbeat

Your doctor will first perform a physical exam. One of the initial things that he/she will do is ask you to swallow while your doctor feels your throat.

Your doctor will also look for signs and symptoms of hyperthyroidism, such as tremor, overly active reflexes, and a rapid or irregular heartbeat. He or she will also check for signs and symptoms of hypothyroidism, such as a slow heartbeat, dry skin and facial swelling.

Blood tests and radiologic imaging such as ultrasound, may also be used to diagnose thyroid nodules.

Most benign thyroid nodules can be treated with “watchful waiting,” when your doctor simply watches your condition at office visits, or with hormone therapy. Surgery will be considered if:

• the nodule is so large that it makes it hard to breathe or swallow.
• the module is a large multinodular goiter, particularly when the goiter constrict airways, the esophagus or blood vessels.

Nodules diagnosed as indeterminate or suspicious by a biopsy also need surgical removal, so they can be examined for signs of cancer.