Understanding Thyroid Nodules Video – Brigham and Women’s Hospital

Trevor E. Angell, MD, MHS, Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women’s Hospital, discusses thyroid nodules.

What are thyroid nodules?
Thyroid nodules are discrete lesions within the thyroid that can be thought of as a mass or a lump. They can represent many different things, as opposed to just thyroid enlargement, which is sometimes called a goiter. Thyroid nodules are more common in older individuals and women are more likely to develop thyroid nodules than men.

What are the risk factors for developing thyroid nodules?
There are a number of things that may increase the risk of having a thyroid nodule, one of which is iodine deficiency, although that’s rare in the United States. People who have had radiation exposure to the area in the neck where the thyroid is located, particularly if that happened during childhood, are more likely to have thyroid nodules. Also, people with an underlying autoimmune thyroid disease, which is sometimes called Hashimoto’s, or lymphocytic thyroiditis, may develop thyroid nodules.

What are the symptoms of thyroid nodules?
Most thyroid nodules are asymptomatic and they’re often found incidentally on different kinds of testing but a number of them can be either felt by a physician as a small firm lump where the thyroid is located in the neck.

How are thyroid nodules evaluated?
Almost all thyroid nodules are benign. The primary way to evaluate a thyroid nodule without removing it surgically is what’s called a fine-needle aspiration biopsy. In this procedure a very small needle is put into the neck where the thyroid nodule is located and cells are collected for evaluation. It’s a short well-tolerated procedure that’s usually done under local anesthetic. Patients are able to go home afterwards with very few issues.

When is surgery needed?
Surgery can be required for the treatment of thyroid nodules in a variety of situations. If the thyroid nodule is found to be a malignancy, typically a thyroid cancer, the standard treatment at this point is a surgery to remove that nodule along with the thyroid in its entirety.

There are other cases in which surgery will be necessary. Some nodules, even after biopsy can’t be definitively described as benign or malignant. In this case the nodule may need to be removed surgically to determine what it is. There are also cases in which benign thyroid nodules need to be removed surgically because they are compressing in a place that’s causing symptoms that aren’t well tolerated.

Learn more about treatment for thyroid nodules at Brigham and Women’s Hospital: https://www.brighamandwomens.org/medicine/endocrinology-diabetes-and-hypertension/thyroid-nodule-clinic-and-thyroid-tumor-clinic

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