Lesions that are different from the surrounding thyroid tissue and can be distinguished radiologically are called thyroid nodules. The nodule or nodules in the thyroid gland are usually detected by the patient as a swelling in the front of the neck or during an examination performed due to another medical necessity or during tests such as ultrasound or tomography.
As the size of the nodule or nodules increases, a feeling of pressure and squeezing in the lower part of the neck. or complaints such as stinging when swallowing increase. Sometimes, hoarseness, hoarseness, or a raspy cough may be the first symptom.
Thyroid nodules are very common in the general population (20-76%), and many of them may never be noticed. The rate of spontaneously noticed nodules is 3-7%, most of which are harmless and close monitoring without any treatment is the most preferred method.
It is known that most thyroid diseases can also be seen in other family members, and this is the case with thyroid nodules.
When a thyroid nodule is detected, the most important approach is to determine whether the nodule is benign or malignant. The probability of the nodules being malignant is 5%. The possibility of the nodule being malignant increases in children, those exposed to radiation, and those with a family history of thyroid cancer.
The procedures to be performed on a patient with a thyroid nodule is a good anamnesis and physical examination, thyroid function tests (TSH and Ft4, calcitonin, thyroid antibodies). ), ultrasonography, thyroid fine needle aspiration biopsy (TINAB) for risky nodules, and thyroid scintigraphy for those with suppressed TSH levels only.
For solid nodules over 1 cm or over 0.5 cm in the risk group, 1- Biopsy should be performed for 1.5 cm hyperechoic nodules and 1.5-2 cm mixed structure nodules. There is no need to perform a biopsy for nodules that are only cystic; if they grow too large, they can be drained.
Thyroid biopsy is a very effortless procedure that can be completed in a short time and will not prevent the patient from daily life. It can be performed under ultrasound guidance for nodules that cannot be felt by hand.
If the patient with a nodule also has a hormonal disorder, drug treatment is applied.
For nodules with local compression findings, constantly growing, suspicious ultrasound findings, or due to cosmetic needs. Surgical treatment is applied.
Radioactive iodine therapy (RAI) can also be applied to specially selected patients. It should not be forgotten to perform a pregnancy test on young female patients before RAI treatment.
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