Solitary Thyroid Nodule

What is a Solitary Thyroid Nodule?

A Solitary Thyroid Nodule (STN) is a single lump in the thyroid gland. Thyroid nodules are quite common and are often found by accident during regular check-ups or imaging tests. Not all nodules need further testing unless they can be felt, are larger than 1 cm, or both. The main concern with thyroid nodules is to rule out thyroid cancer, which occurs in about 5% of cases. STNs have a higher chance of being cancerous and need to be examined carefully for proper treatment.

Who is at Higher Risk for Malignant Thyroid Nodules?

Certain groups are more likely to have cancerous thyroid nodules, including:

• Children
• Adults under 30 years old
• People with a history of radiation exposure to the head and neck
• Those with a family history of thyroid cancer

What Causes Solitary Thyroid Nodules?

Possible causes of STNs include:

• Multinodular goiter (enlarged thyroid with multiple nodules)
• Thyroid cancer
• Thyroid cysts
• Iodine deficiency
• Overgrowth of normal thyroid tissue

What are the Symptoms of Solitary Thyroid Nodules?

Most people with STNs don’t have symptoms, but large nodules might cause visible swelling in the neck. If they press on the windpipe, they can cause shortness of breath or difficulty swallowing.

How to Diagnose Solitary Thyroid Nodules?

Diagnosis involves several steps:

1. Medical History and Physical Examination: Doctors start with a thorough medical history and physical exam.
2. Thyroid-Stimulating Hormone (TSH) Test: A blood test to check if the thyroid is working properly.
3. Thyroid Ultrasound: An ultrasound helps determine the size and features of the nodule and identifies which nodules need a biopsy.
4. Fine-Needle Aspiration (FNA) Biopsy: A needle is used to take a small sample of the nodule for examination under a microscope. This test can tell if the nodule is benign (non-cancerous), suspicious, or malignant (cancerous).
5. Thyroid Scan: This scan is done if the TSH levels are low to see if the nodules are producing too much hormone or not functioning at all.

How to Treat Solitary Thyroid Nodules?

Treatment depends on the biopsy results:

• Benign Nodules: No surgery is needed. The nodule is monitored, and another biopsy is done if it changes in size. Thyroid hormone therapy might be tried to shrink the nodule.
• Malignant Nodules: Treatment is based on the type of cancer. It may involve removing part of the thyroid (lobectomy) or the entire thyroid (total thyroidectomy), followed by thyroid hormone therapy.