Attitude to a thyroid nodule

Written by: Dr. Ramón Díaz Conradi
Edited by: Anna Raventós Rodríguez

A thyroid nodule is the growth of a protuberance in the thyroid gland. This presence in the thyroid implies that there is a nodular tumor with a sufficient diameter to be palpable. Thyroid nodules can be both benign and malignant, and the most common are nodular hyperplasia, follicular adenomas, thyroid cancer, and thyroiditis.


It is more common among women of middle ages, and prevalence increases with age. However, the data for optimism is that almost all of the nodules are benign.


Symptoms of thyroid nodule

Many nodules are asymptomatic, but compressive symptoms are rare as long as the lesion does not exceed five or seven centimeters. In the case of compressive symptoms of adjacent anatomical structures, these will be manifested as alterations of the voice, hoarseness, pain in neck, difficulty to swallow or respiratory problems.


Very few patients with a thyroid nodule present with hyperthyroidism , ie an excess of activity of the thyroid gland. Diagnostic and therapeutic tests in the thyroid nodule.

The thyroid nodule is more common among middle-aged women,and prevalence increases with age

Apart from clinical examination, thyroid hormone determinations. If these are normal levels and the nodule is less than ten millimeters, in addition to not having risk factors for malignization, the attitude that must be followed is conservative, performing clinical and analytical follow-up to the patient in the consultation. However, there is some controversy as to whether it is necessary to perform thyroid scintigraphy in nodules with normal thyroid hormone, although we do it if there is any doubt about the existence of hyperthyroidism.


At the same time, it is also debatable whether a CT scan or magnetic resonance imaging. These can be done for a more detailed analysis of the location and if there is any doubt about its malignancy.


If hormone levels are normal but the nodule is greater than ten millimeters or there are risk factors for malignancy, a thyroid ultrasound and a PAAD (Fine Needle Aspiration) should be performed to determine if the nodule is malignant or benign. If the nodule is benign it is recommended to follow the same in the consultation using analytical and ultrasound control. If, on the other hand, it is a malignant nodule, a surgical procedure, total thyroidectomy, must be performed, which involves the complete removal of the thyroid gland.


On the other hand, if thyroid hormones are elevated at first, an ultrasound of the thyroid gland. Nodules larger than 3 centimeters are advisable to remove them by surgery, and will be treated as benign nodules if there is no suspicion of malignancy on the ultrasound or FNA.


If the thyroid nodule is benign but produces compressive symptoms, surgery will also be indicated. However, in this case it can be resolved with a hemithyroidectomy, ie, removal of the affected part of the thyroid gland.


For more information, consult a specialist in General Surgery .

*Translated with Google translator. We apologize for any imperfection

By Dr. Ramón Díaz Conradi

Dr. Diaz Conradi has made since 1990 over 3,200 interventions in Laparoscopic Surgery, covering all types of digestive diseases (liver, gallbladder, bile duct, pancreas, esophagus, stomach, small intestine, colon and rectum), spleen, morbid obesity (bands and by-pass), adrenal surgery and emergency surgery (abdominal trauma, acute appendicitis, cholecystitis, intestinal obstruction, perforation of hollow viscera and urgent adnexal pathology). In addition, he is a frequent speaker and lecturer at the Universidad San Pablo CEU.

*Translated with Google translator. We apologize for any imperfection

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