Thyroid nodules are small “balls” that form inside the thyroid, an endocrine gland located in the front of the neck that produces hormones vital to our metabolism. They are more common in women, although many are unaware of them because the nodules are often asymptomatic.
We talked about it with Dr. Damiano Chiari , general surgeon at Humanitas Mater Domini and the Humanitas Medical Care clinic in Arese .
What are thyroid nodules?
These are growths that develop inside the thyroid and can alter its appearance. They can be liquid , solid , or a mixture . They are generally benign nodules that cause no symptoms or discomfort .
How common are thyroid nodules?
It is a very common disease in the general population, occurring more frequently in women and with advancing age . Studies published in the scientific literature show that at least 25% of the population has thyroid nodules.
When is a thyroid nodule suspicious?
Fortunately, only a small percentage of nodules are found to be cancerous. The suspicion of a nodule’s malignancy sometimes arises from the patient’s coexistence with particular conditions (e.g., family history, enlarged lymph nodes, etc.), but more frequently, from the characteristics of the nodule itself , which can be determined by ultrasound and, where necessary, fine-needle aspiration.
How is a thyroid nodule diagnosed?
As we were saying, thyroid nodules are often asymptomatic and patients discover them almost by chance, during diagnostic check-ups or when prescribed for other reasons.
However, to confirm the diagnosis of a thyroid nodule, it is necessary to perform a thyroid ultrasound with color Doppler : it allows for a precise study of the presence and size of the nodules, the degree of vascularization and their structure (solid, liquid, mixed).
What further information can be recommended:
- Blood tests: these allow us to evaluate thyroid function and the possible coexistence of autoimmune thyroid diseases.
- Thyroid scintigraphy : It is useful for patients with hyperthyroidism in whom one of the nodular formations is suspected to be hyperfunctioning.
- Fine needle aspiration of the thyroid nodule : some cells are taken from the nodule and subjected to cytological examination to define their nature.
How can a thyroid nodule be treated?
If the nodules are benign, asymptomatic, small, and do not compromise thyroid function, only periodic monitoring is recommended . It is important to undergo follow-up tests (TSH, FT3, and FT4) and an annual ultrasound, relying on an experienced sonographer to evaluate the nodule’s characteristics and, if necessary, recommend any additional tests, such as fine-needle cytology if the nodule changes over time.
In the presence of hyperfunctioning nodules that produce excess thyroid hormones, medications are prescribed to reduce the thyroid’s production of thyroid hormones. Nuclear medicine radiotherapy (radioiodine) may then be indicated to reduce the nodule’s function, or surgery may be performed .
Surgery is also recommended in the case of a benign nodule that is large in size and/or causes compressive discomfort (problems breathing or swallowing) or in the case of a nodule that is found to be malignant on fine needle aspiration.
How are thyroid nodules removed?
Surgery is required to remove thyroid nodules. Commonly performed thyroid surgeries involve removing the entire gland ( total thyroidectomy ) or removing just one of the two lobes that make up the gland ( hemithyroidectomy or loboisthmectomy ). The procedure is performed under general anesthesia and usually requires a one- or two-night stay in the hospital.
How does it feel after having your thyroid removed?
After thyroidectomy, hormone therapy is administered to replace the hormones previously produced by the thyroid, allowing a normal life to return. In cases of hemithyroidectomy alone, this therapy is often not necessary because the residual lobe can produce the necessary hormones. However, after surgery, it is very important to be monitored by an endocrinologist to maintain the correct dosage of hormone therapy.
