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Thyroid Nodules

Your thyroid is a small, butterfly-shaped gland in your neck that regulates your heart rate, metabolism, blood pressure and body temperature. Small bumps called nodules can develop in your thyroid. These nodules may be either solid or filled with fluid. The majority of thyroid nodules are noncancerous, but they may still cause problems so they should be checked by a doctor.

What are thyroid nodules?

Nodules are small lumps that may be either solid or fluid-filled and that develop on the thyroid gland. Most thyroid nodules do not cause symptoms and are not serious. A small percentage of thyroid nodules are cancerous.

You may not realize you have a thyroid nodule unless your doctor finds it during a routine medical exam or it shows up on a scan you undergo for another health reason. However, some thyroid nodules may cause a lump in your throat or neck that can become visible or make it harder to breathe or swallow.

Thyroid nodules may be caused by an overgrowth of thyroid tissues, thyroid cysts, chronic inflammation of the thyroid, goiter (any enlargement of the thyroid gland), iodine deficiency (this is rare in the United States) or thyroid cancer.

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Thyroid nodule symptoms and risks

Most thyroid nodules don't cause signs or symptoms. They may, however, become large enough to cause:

  • Swelling at the base of the neck
  • A hoarse voice
  • Coughing
  • Difficulty breathing or swallowing
  • Dizziness

Sometimes, thyroid nodules will cause your thyroid to produce more of a hormone called thyroxine and this may cause symptoms of hyperthyroidism, or overactive thyroid. These symptoms include:

  • Unexplained weight loss
  • Tremor
  • Nervousness
  • Irregular or rapid heartbeat

While most thyroid nodules will cause few, if any, symptoms, a small number are cancerous. A cancerous thyroid nodule cannot be determined by evaluating your symptoms alone.

Thyroid nodule diagnosis and screening

There are several ways thyroid nodules may be diagnosed. Your doctor may be able to detect a thyroid nodule by examining your neck to feel your thyroid gland. A thyroid ultrasound may be used to produce images of your thyroid gland to evaluate any lumps or nodules that might show up.

Your doctor may also order a thyroid function test to measure levels of the hormones your thyroid produces. The test can't detect if a thyroid nodule is cancerous, but it can help rule out other possible thyroid conditions.

You may also need to undergo a fine-needle aspiration test. Your doctor will use an ultrasound to guide needle placement to take several samples of the thyroid nodule. The samples will then be tested by a pathologist to determine if the nodule is cancerous.

Thyroid nodule treatment

After your thyroid nodule is discovered, your doctor will determine whether the rest of your thyroid is still healthy. This may be done by ultrasound or fine needle biopsy. Additional laboratory tests may be conducted to determine if your thyroid is still functioning normally.

Traditional treatments for problematic thyroid nodules or thyroid cancer are total thyroidectomy or hemithyroidectomy – surgical removal of all or part of the thyroid. Thyroid cancer may also be treated with radioactive iodine therapy. New minimally invasive endoscopic techniques have been developed for the management of thyroid nodules.

One of the less invasive techniques our neurointerventional radiology and interventional radiology teams now offer is thyroid radiofrequency ablation (RFA). It treats the nodules while preserving healthy thyroid tissue. The nodule is located using ultrasound-guided imaging, allowing the treatment to focus solely on the targeted nodule. Your doctor then uses a tiny electrode to allow a carefully controlled amount of energy to flow into the tissue that degenerates the nodule with heat.

The deteriorated tissue will flow through your body naturally as waste over the course of a few months. Most patients notice a reduction in the size of the nodule in just 2 or 3 weeks.

Because a thin needle is used, the process won't leave a surgical scar. No general anesthesia is required, which means no hospitalization is required and you will experience less downtime. Additionally, because your healthy thyroid tissue is preserved, your thyroid will continue to function without medication.

The complications from treating thyroid nodules with RFA are mild, rare and similar to what you might experience with surgery.

Why choose us for thyroid nodules

As part of an academic medical center, you have access to most advanced treatments and specialists who treat thyroid nodules including primary care specialists; endocrinologists; ear, nose and throat specialists; interventional radiologists and more. Our ear, nose and throat and endocrinology teams are regularly recognized by U.S. News & World Report as among the nation's best.

Our neurointerventional radiology and interventional radiology teams have years of combined expert experience. They are among only 75 physicians in the U.S. who perform thyroid radiofrequency ablation. Radiofrequency ablation has been extensively studied and used for treatment of many conditions including pain management, heart rhythm conditions, varicose veins and tumors.

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