THYROID NODULE

General Information

DEFINITION--A benign or malignant nodule involving the thyroid gland in the front of the neck. Benign tumors are much more common and are unlikely to spread to other body parts. These growths may be cystic or solid (thyroid adenoma). Malignant thyroid nodules can spread and threaten life. Early symptoms of both types are the same.

BODY PARTS INVOLVED--Thyroid gland in the front of the neck.

SEX OR AGE MOST AFFECTED

• Both sexes, but benign nodules are more common in women than men.
• All ages, but malignant nodules are more likely in children between ages 4 and 7.

SIGNS & SYMPTOMS

• Swelling or lump in the thyroid gland.
• Pain and tenderness in the thyroid gland.
• Swallowing difficulty.
• Hoarseness.
• Breathing difficulty (rare).
• Symptoms of hypothyroidism or hyperthyroidism (both in Illness section).

CAUSES--Unknown.

> Radiation treatment during childhood--even in small doses--

to the head, neck and upper chest.

• Family history of thyroid tumors.
• Iodine deficiency.

HOW TO PREVENT--Avoid radiation treatments to the neck for acne, tonsillitis, enlarged thymus gland or other minor conditions.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory tests, such as thyroid scans, needle biopsy, ultrasound (See Glossary for all), and x-rays. Tests help rule out cancer and avoid unnecessary surgery.

APPROPRIATE HEALTH CARE

• Treatment varies and may involve one or a combination of therapies.
• Suppressive doses of thyroid hormone may be used for some cases, both as an aid in diagnosis and as a treatment. If nodules increase in size, surgery is recommended.
• Surgery to aspirate a cystic tumor or to remove a solid tumor and the affected lobe of the thyroid (near-total thyroidectomy; lobectomy).
• Radioactive iodine treatment.

POSSIBLE COMPLICATIONS

• Spread of a malignant tumor to adjacent parts, requiring radical surgery to remove lymph nodes and muscles of one side of the neck.
• Hypothyroidism or hypoparathyroidism, caused by inadvertent injury to the thyroid or parathyroid glands during surgery.
• Permanent hoarseness and loss of voice following surgery for some thyroid cancers.

PROBABLE OUTCOME--Usually curable with surgery or a combination of surgery and radioactive-iodine treatment.

How To Treat

GENERAL MEASURES--

• For an explanation of surgery and postoperative care, see Thyroidectomy (in Surgery section).
• See Resources for Additional Information under Cancer and Thyroid.

MEDICATION--Your doctor may prescribe:

• Antithyroid medications or replacement thyroid hormone.
• Radioactive iodine to treat cancer (I-131).
• Pain relievers.

ACTIVITY--

• Resume your normal activities as soon as symptoms improve after surgery.
• Speech therapy may be recommended if the voice is affected after surgery.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of thyroid nodules or thyroid enlargement.
• The following occurs after surgery: Symptoms of hypothyroidism (fatigue, puffy face, rapid weight gain, coarse hair and decreased sex drive). Bleeding, pain or swelling at the surgical site. Fever. Twitching muscles. Breathing difficulty.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.