How to treat thyroid nodules?

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 03, 2024
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Clinically, if a thyroid nodule is confirmed to be a benign tumor, generally speaking, if thyroid function is normal and the nodule is not large, urgent treatment is not necessary, and regular follow-up is sufficient. If the thyroid nodule significantly enlarges, causing compression of the trachea or nerves, surgery should be considered. Furthermore, for ectopic growth of thyroid tissue behind the sternum, surgical removal is also considered necessary. Another scenario that requires special mention is if a thyroid nodule grows rapidly in a short period and ultrasound suggests calcification or bleeding within the cyst, thyroid cancer should be suspected. In this case, it's advisable to have the nodule surgically removed.

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Written by Luo Han Ying
Endocrinology
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Post-thyroidectomy complications

In clinical practice, for large thyroid nodules that cause compressive symptoms, such as difficulty swallowing, breathlessness, and hoarseness, thyroid nodule excision surgery can be performed. However, this surgery can have sequelae. First, if the excised thyroid tissue is too large, it can easily lead to reduced thyroid function, requiring lifelong supplementation with thyroid hormones for treatment. Secondly, due to the sensitive location of the thyroid gland, which is surrounded by various glands and nerves, injury during surgery can lead to complications such as seizures and hoarseness, which are considered post-surgical sequelae.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Symptoms of thyroid nodules

Thyroid nodules in the early stages often show no clear symptoms, with only small nodules appearing within the body. The size of these nodules can range from several millimeters to several centimeters, and their texture is generally slightly harder compared to the surrounding glandular tissue. When the enlargement is more noticeable, the nodule can move up and down with the thyroid gland during swallowing. In addition to the presence of nodules, when the thyroid nodule is prominent, it can compress the trachea, leading to difficulty breathing and irritative dry cough. If it compresses the recurrent laryngeal nerve, it may cause hoarseness, varying degrees of hoarseness, and even an inability to speak loudly. In patients with malignant nodules, the invasive malignant cells can cause symptoms such as hoarseness, difficulty breathing, dysphagia (difficulty swallowing), diarrhea, palpitations, facial flushing, and decreased blood calcium levels. If these symptoms occur, it is crucial to seek medical attention promptly.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Is thyroid nodule ablation a good treatment?

Thyroid nodule ablation has its advantages over traditional surgery, but it also has its shortcomings. The advantages include minimal trauma, less bleeding, and less pain for the patient. Ablation involves inserting an ablation needle through the skin of the patient's neck, directly into the tumor to perform the ablation with the goal of eliminating the nodule. Since it does not require cutting, it reduces damage to surrounding tissues and bleeding, allowing the patient to resume activities earlier and reduce suffering. However, the drawback is that ablation is effective for smaller benign thyroid masses, but for complex or malignant thyroid nodules, the treatment effectiveness is poor, and its use is not advocated.

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Written by Lin Xiang Dong
Endocrinology
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Where to do acupuncture for thyroid nodules?

Thyroid nodules do not require acupuncture treatment. The vast majority of thyroid nodules are benign, with only a small portion, about 5%, being malignant. We generally determine the treatment approach based on whether the nodule is benign or malignant. For benign nodules, we typically follow up with observation, while malignant nodules require surgical treatment and oral medication, or Iodine-131 radiotherapy. The primary evaluation for distinguishing between benign and malignant nodules relies on the results of color Doppler ultrasound and the pathology results from thyroid fine-needle aspiration.

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Written by Li Jin Quan
General Surgery
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Thyroid nodule calcification meaning

In our thyroid ultrasound, terms like thyroid nodule calcification are often seen. Thyroid nodule calcification is a form of self-healing. It can be divided into large and small nodule calcifications. Generally, large nodule calcifications have a very low proportion of malignancy. The possibility of malignancy in smaller calcifications is relatively higher. When we see a report indicating thyroid nodule calcification, there is no need to panic. We can consult specialists such as thyroid surgeons, who will tell you how to distinguish between benign and malignant conditions. I recommend performing thyroid cytological puncture, which, through pathological examination, can determine whether the thyroid nodule calcification is benign or malignant.