Is thyroid nodule dangerous?

The thyroid gland is butterfly-shaped, consisting of two lobes connected by the isthmus, located in the middle and front of the neck. This is an important endocrine gland, responsible for the production of thyroid hormone, which helps the body use energy, keep warm, and help the brain, heart and many other organs to function normally. In addition, the thyroid gland also secretes the hormone calcitonin, which is involved in the regulation of calcium levels in the blood.

Doctor.CKI Phan Thi Thuy Dung (Department of Endocrinology, Tam Anh General Hospital in Ho Chi Minh City), said that nodules appear in the thyroid gland at any age, mainly women. Some studies show that by the age of 60, about half of the population has thyroid nodules, but 90% of cases are benign, do not turn into cancer, only 5-10% of cases are malignant.

Dr. Thuy Dung added that most cases of thyroid nodules have no known cause, especially iodine deficiency has been identified as a causative factor. The frequency of thyroid nodules is palpable on manual examination, with an incidence of about 5% in women and 1% in men, mainly in patients living in iodine-deficient areas, but in practice most thyroid nodules are small, not palpable. Therefore, a normal examination may miss thyroid nodules.

“However, with the development of ultrasound, now the frequency of detecting thyroid nodules can be up to 19-68%. The anatomical structure of the female body undergoes many hormonal changes: puberty. , menstruation, pregnancy and childbirth, lactation and menopause are thought to be risk factors for thyroid nodules,” added Dr.

Thyroid nodule can be a thyroid nodule – benign thyroid nodule, can be malignant thyroid nodule. Most thyroid nodules do not alter thyroid function. However, some thyroid nodules can increase activity, produce an excessive amount of thyroid hormone causing hyperthyroidism with the expression of weight loss, palpitations, palpitations, tremors, muscle weakness… Bleeding in the thyroid capsule will cause pain in the neck, jaw, and ears.

A thyroid nodule that is large enough can put pressure on the airways or esophagus, which can make it difficult to breathe or swallow, or a sore throat or cough. In rare cases, the thyroid nodule compresses the laryngeal nerve causing hoarseness but is often associated with thyroid cancer.

Signs of thyroid nodules

According to Dr. Thuy Dung, people with thyroid nodules mostly have no symptoms. The disease was discovered by chance during a general physical examination, examining other unrelated diseases through screening films such as CT scans, neck ultrasound. or abnormal thyroid function tests.

In a small number of cases, when the goiter is large, there will be symptoms of compression such as difficulty swallowing, shortness of breath, cough, hoarseness or pain when there is bleeding in the thyroid capsule… The neck area has a big block or when the buttons are buttoned, it feels cramped.

How to detect thyroid patients?

Dr. Thuy Dung shared, the best way to detect thyroid nodules is to examine the neck area, including palpating the thyroid gland and thyroid ultrasound to help detect non-palpable thyroid nodules. The patient also has thyroid hormone (Thyroxine, or T4) and thyroid-stimulating hormone (TSH) blood tests to determine if the thyroid gland is functioning normally.

In some cases where a thyroid nodule cannot be determined to be cancerous (very low malignancy rate) by physical examination and blood tests, special tests such as ultrasound and needle aspiration are needed. small.

With ultrasound, the patient has an ultrasound of the thyroid gland with high-frequency sound waves to help evaluate thyroid nodules. The doctor will see if the thyroid gland has one or more nodules, has increased in size or not, and determines the size of the nodule. Ultrasonographic results also identify solid or cystic nodules and features suspicious of thyroid nodules as malignant or benign. If nodules are benign, doctors usually don’t need to remove them, just monitor them over time, unless they cause symptoms of choking or difficulty swallowing. Ultrasound for follow-up is important.

After completion of the initial evaluation, thyroid ultrasound can be used to non-operatively monitor thyroid nodules to determine whether the nodule has grown over time and to monitor the risk of progression to cancer. letter from the man of the zodiac. Ultrasonography also helps to accurately position the needle directly into the nucleus when aspiration thyroid cells with fine needles for thyroid nodules with suspicious features of malignancy on thyroid ultrasound.

Fine needle aspiration thyroid cytology (FNA) is a procedure that helps to initially assess the cytological nature of the thyroid nodule as benign or malignant. The doctor will use a very small needle, under the guidance of ultrasound, to go into the right place of the thyroid nodule, aspirate cells from the thyroid nodule. The smear is then examined under a microscope so that the pathologist can find cancer cells. Malignant thyroid nodules account for 5%-10%, usually due to papillary carcinoma, which is the most common type of thyroid cancer. If cancer is found, the entire thyroid gland is removed by an experienced physician.

Treatment and prevention of thyroid nodules

With thyroid nodules – benign thyroid nodules are usually followed up without surgery. However, patients are monitored by ultrasound, the first phase is from 12-24 months, then gradually increases over time from 2-5 years. But if the thyroid nodule has the following abnormalities, it should be thoroughly evaluated, including: significant growth such as volume change by more than 50% or increase of 20% in diameter with minimal increase in two or more dimension is at least 2 mm or there are abnormal signs on ultrasound, symptoms of invasive compression in the neck area, suspicious cervical lymph nodes…

In cases of malignancy, including papillary carcinoma, medullary thyroid cancer, thyroid lymphoma, aplastic cancer, and cancer metastasized to the thyroid gland. Patients with a cytological diagnosis of malignancy should undergo surgery.

In addition, depending on each specific case, the doctor will have a different treatment regimen for thyroid patients. Subjects who need thyroid examination for early detection of malignant thyroid nodules (thyroid cancer) include: young people under 14 years old or older people over 70 years old, thyroid nodules are detected, thyroid nodules are rapidly growing in size. size, symptoms of hoarseness, a history of radiation therapy to the head, face and neck, or a family history of thyroid cancer.

Most cases of thyroid cancer are curable and rarely cause life-threatening problems if detected early and treated promptly.

Dinh Tien