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 Hu Jian Zhuo
Nephrology and Endocrinology
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Does thyroid nodule puncture hurt?

Fine needle aspiration is an invasive examination, but it is currently an important and most efficient method for assessing benign and malignant conditions, generally conducted under ultrasound guidance. Thyroid nodule aspiration does not cause much pain, similar to that of an injection. Anesthetics are used during the procedure, so the pain is not very noticeable. However, as the effect of the anesthetic wears off, there may still be some pain at the puncture site, but the patients do not need to carry a heavy psychological burden.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Are thyroid nodules serious?

The severity of thyroid nodules needs to be assessed based on their nature, size, function, and location. Generally, they can be classified into benign and malignant, with malignant nodules being thyroid cancer, which requires timely treatment. Surgical treatment is the main method for treating thyroid cancer, whereas most benign nodules do not require special handling. Regarding the size of the thyroid nodules, if the nodules are too large and compress surrounding tissues such as the trachea, esophagus, and nerves, surgical treatment is recommended. For common benign nodules, regular observation is sufficient. Functionally, some thyroid nodules may affect thyroid function, such as in Hashimoto's thyroiditis, which can present with diffuse multiple nodules, leading to either hyperthyroidism or hypothyroidism. In such cases, appropriate medication treatment is needed. From a positional perspective, ectopic growth of thyroid nodules, if located at areas like the base of the ear, pharynx, neck, esophagus, or thoracic cavity, is a rare congenital developmental anomaly. If such a nodule significantly enlarges and compresses surrounding tissues, surgical treatment is advised.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid Nodule Classification Standard

To standardize the diagnosis of thyroid diseases, we have categorized thyroid nodules into six levels, with the severity and the likelihood of malignancy increasing with each level: Grade 1 refers to normal thyroid tissue; Grade 2 indicates benign changes in the thyroid, with the risk of malignancy increasing over time. For example, simple thyroid cysts, which require an ultrasound check every 1-2 years; Grade 3 refers to the presence of nodules in the thyroid with a malignancy possibility of

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Written by Zhang Jun Jun
Endocrinology
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The difference between thyroid nodules and nodular goiter

Thyroid nodules are the clinical manifestations of nodular goiter, and nodular goiter is the cause of thyroid nodules. Nodular goiter generally occurs in iodine-deficient areas, forming these partial or multiple thyroid nodules. Thyroid nodules are the clinical manifestations of nodular goiter; the nodules in the thyroid can be single or multiple and can cause abnormal thyroid function, although thyroid function can also be normal in the early stages. Therefore, when performing an ultrasound, if thyroid nodules are discovered, it is necessary to further assess thyroid function and dynamically track changes in the size of the thyroid nodules to determine whether it is nodular goiter.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Do thyroid nodules require surgery?

Whether thyroid nodules require treatment generally depends on medical guidelines. Thyroid nodules larger than 1cm with malignant features typically require biopsy. The decision for a biopsy should be made by a professional ultrasonographer after examination. Therefore, upon detecting a nodule, it is crucial to visit a specialized hospital for further ultrasound examination. If the nodule is malignant, we recommend surgical removal. If it is benign, close observation is advisable. However, treatment is necessary under the following conditions: First, if the nodule is too large and compresses other organs, causing breathing difficulties, localized swelling, pain, or other discomforts. Second, if the nodule grows quickly, increasing in volume by more than 50% within six months, the possibility of malignancy should be considered and treatment is needed. Third, if the thyroid nodule is located behind the sternum, which is called an ectopic thyroid nodule, surgical treatment is necessary. If the thyroid nodule is large enough to affect the aesthetics of the neck, surgical treatment may also be considered.