Causative & risk factors
Thyroid nodules tend to run in families. Exposure to radiation is associated with a higher risk of developing thyroid nodules. Dietary deficiency of iodine can give rise to thyroid nodules. Thyroid adenomas, thyroid cysts or multinodular goiters are common causes of thyroid nodules. Chronic thyroiditis can also give rise to nodule formation. Sometimes thyroid nodules arise as a result of malignancy.
Clinical presentation
In most patients, presence of one or more thyroid nodules does not give rise to any symptoms. Rarely large nodules can give rise to pain or difficulty in swallowing. Breathing difficulties may also arise occasionally.
A large thyroid nodule can be seen or felt in the neck region.
Sometimes a nodule starts producing too much thyroid hormone, thus giving rise to symptoms of hyperthyroidism.
Investigations
The thyroid hormone levels in the blood will be measured.
Thyroid ultrasound or a thyroid scan will be carried out.
A fine needle aspiration biopsy (FNAC) of a thyroid nodule can help to detect whether a nodule is benign or malignant.
Treatment
Benign and asymptomatic thyroid nodules only need to be monitored; no treatment is necessary.
If hyperthyroidism is also present, the patient will need anti-thyroid medication or radioactive iodine to normalize the levels of thyroid hormone. Surgical removal of a thyroid nodule is considered, especially if it produces too much thyroid hormone.
Malignant thyroid nodules are treated with a combination of surgery and radiation therapy.
