The thyroid gland, located in the lower part of the neck and in front of the trachea, secretes thyroid hormones that have great effects on our body, although it is a small organ. When thyroid hormone is secreted too little or too much, it can cause various health problems. In addition, nodules in the thyroid gland also threaten our health. General Surgery Specialist Prof. Dr. Can Küçük states that large nodules that carry the risk of cancer and put pressure on the trachea must be operated on.
Thyroid problems can be mistaken for goiter
Popularly speaking, The enlargement and visible appearance of the thyroid gland is called 'goiter'. However, there are many 'thyroid gland disorders' under the name of goiter, whose causes, diagnostic methods and treatments are extremely different. Prof. says that each of the situations such as overfunctioning, underfunctioning, enlargement of the gland or the formation of structures called nodules are a separate health problem. Dr. Can Küçük gives the following information: “If there is a lump in the thyroid gland, it is called 'thyroid nodule'. If the thyroid gland is both large and nodular, it is called 'nodular goiter', and if it is both large and has multiple lumps, it is called 'multi-nodular goiter'.
Nodules have three important aspects for the person and the doctor. It has many features and these play an important role in the course of the disease. The first is whether the nodule is cancerous, the second is whether the nodule or nodules work autonomously and cause the disease called hyperthyroidism with excessive hormone production, and the third feature is whether it puts pressure on the trachea, which is seen in large nodules.
What is hypothyroidism and hyperthyroidism?
The most common thyroid problem; Hypothyroidism, known as underactivity of the thyroid gland. If thyroid hormones are secreted less than normal, problems such as hair loss, constipation, decrease in sweating, fatigue/weakness, weight gain, chills, memory problems, depression, dry skin and menstrual irregularity in women occur. If thyroid hormones are secreted more than normal, a condition called hyperthyroidism occurs. Hyperthyroidism, weight loss/inability to gain weight, palpitations, tremors in the hands, intolerance to heat, eye symptoms (eye symptoms) It manifests itself with symptoms such as the eyelid being more open than normal and the eye protruding forward, etc.), irritability, excessive excitement and emotionality.
Surgery should be performed at the right time
Patients with large nodules that cause mechanical compression require 'surgery' as a solution. If the patient's thyroid hormones are normal, surgery can be performed immediately. However, if there is excessive hormone production along with a large nodule, the hormone levels should first be brought to normal with medications and then surgery should be performed, Prof. Dr. Can Küçük said, “If the patient's nodule or nodules are autonomous, that is, overactive nodules, this should be proven with T4 and TSH blood tests and it should be determined that the nodules are hot nodules with thyroid scintigraphy. Since hot nodules are usually not cancerous, a needle biopsy is not needed. If there is a single hot nodule, it can be treated by giving 'radioiodine'. "If the hot nodule is very large (2 cm) or there are many hot nodules, then surgical treatment is required," he says.
5 percent are suspected of cancer
Prof. Dr. Can Küçük says that the majority of thyroid nodules are nodules that do not cause compression and do not produce much hormone. Cancer is suspected in 5 percent of these nodules. Therefore, without panicking, it is important to know that 95 percent of these nodules are not cancer and to consult a specialist to find out which nodules require surgery. After the manual examination performed by the relevant specialist physician, the most important examination is 'thyroid ultrasonography'. If a nodule has suspicious criteria in terms of cancer risk, such as irregular borders, formation of pinhead-like calcium precipitates, and excessive blood supply, it is necessary to first perform a 'fine needle aspiration biopsy' on that nodule. When a sufficiently collected aspirate is examined by an experienced cytopathologist, the reliability rate can reach up to 97 percent.
If there is a suspicion of cancer, surgery is necessary
The result of fine needle aspiration biopsy is Emphasizing that all nodules that cause cancer or cancer suspicion should be operated on, Prof. Dr. Can Küçük continues his words as follows: “In addition, cases with large nodules that put pressure on the trachea due to mass effect should be operated on, even if there is no suspicion of cancer. biopsy All nodules that appear to be good should continue to be monitored with ultrasound, considering that the method used will give 3-5 percent erroneous results. If the nodule grows by 20 percent or more, the needle biopsy should be repeated or surgery should be considered.”
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