Home
My Account
About Us
Forum
Contact us
الواجهة العربية
epharmaweb.com
Medical News Medical News
Aricles Articles
Events Events
Guidelines Guidelines
Videos Library Videos Library
Diseases Diseases
Follow us : facebook twitter Digg Linkedin Boxiz
Newsletter

Please select the categories you are intersted in:
News Articles Guidelines Events Videos Journals' abstracts

Latest Subscribers
Advanced Search »



Thyroid Nodules

Definition


Disease: Thyroid Nodules Thyroid Nodules
Category: Endocrine and metabolic diseases
اضغط هنا للقراءة باللغة العربية

Disease Definition:

Thyroid nodules are formations of either solid or fluid lumps in the thyroid gland, which is a small gland located just above the Adam's apple on the neck.

A small percentage of thyroid nodules are cancerous, but the rest are not and the patients do not experience any symptoms.

A person may not be aware of thyroid nodules until a physician discovers them during a periodic checkup, although in some cases the lumps significantly grow in size to cause swallowing difficulties. The course of treatment will be decided according to the type of thyroid nodule.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

When thyroid nodules become large, they may be felt, or the swelling can be seen at the base of the neck; but in most cases, they don’t cause any signs or symptoms.

The thyroid nodules produce too much thyoxine in some cases, which is one of the hormones normally secreted by the thyroid gland. Nervousness, sudden and unexplained weight loss, and rapid or irregular heartbeats are some of the problems that may result from the extra thryoxine.

When a nodule grows quickly or feels hard, when it causes difficulty swallowing or breathing, when the patient’s voice becomes hoarse, or when it causes enlarged lymph nodes under the jaw or in the neck, then it is more likely to become cancerous or malignant, though this is quite rare.

A doctor should be consulted when someone experiences unusual swelling in the neck, especially if he/she also experiences trouble breathing or swallowing.

In the case of experiencing muscle weakness, nervousness or irritability, a pounding heart, trouble sleeping, and sudden weight loss even though the person’s appetite is normal or has increased, medical care should be sought because these are some of the signs and symptoms of hyperthyroidism.

Causes:

The thyroid is made up of two lobes in the form of a butterfly; its function is to extract iodine from the food to produce two hormones, thyroxine (T4) and triiodothyronine (T3); these hormones regulate the body's use of carbohydrates and fat, body temperature, heartbeat rate, and help in the regulation of protein production. The thyroid also regulates the amount of calcium in the body by production of calcitonin.

It's not known what causes most nodules to develop, but the following factors are sometimes involved:

 

  • Insufficient iodine amount in the diet
  • Hashimto's disease, a chronic inflammation and underactivity (hypothyroidism) of the thyroid gland (an autoimmune disorder)
  • Genetic defect of receptors that release thyroid-stimulating hormone (TSH)
  • Radiation treatment to the head and neck in childhood


Types of nodules in the thyroid may include:

Colloid nodule:
This is the most common type and the patient may have only one or many noncancerous nodules that may grow in size but do not spread out of the thyroid gland.

Follicular adenoma:
This is another type of noncancerous nodule.

Thyroid cyst:
In this case, areas ranging in diameter from 8 to 25 mm are usually filled with fluid and are noncancerous (benign). But there is another case where these cysts also contain solid components; this is called complex cysts which sometimes can be cancerous (malignant).

Inflammatory nodule:
This is a less common type and it occurs as a result of thyroiditis, which is the chronic inflammation of the thyroid gland. An even less common type of thyroiditis called subacute thyroiditis is accompanied with sever thyroid gland pain. There are also other painless types which may occur after pregnancy (postpartum thyroiditis).

Thyroid cancer:
This is indicated by hard, large and painful nodules in the thyroid gland. The risk of cancer is increased for male patients who have family history of endocrine cancers, or patients that do not fall into the age group between 30 and 60 or have a history of exposure to radiation.

Multinodular goiter:
The enlargement of the thyroid gland is called goiter. In this case, it causes tightness in the throat making swallowing and breathing difficult. Goiter is the result of several thyroid nodules present in the gland, among many other factors.

Hyperfunctioning thyroid nodule (toxic adenoma, toxic multinodular goiter, Plummer's disease):
In this case, the formed nodules produce thyroid hormones independent from TSH, which is another hormone produced by the pituitary gland to regulate the production of  thyroid hormones.

Hyperfunctioning thyroid nodules increase the thyroxine level in the blood depriving it from TSH. This condition may also occur due to a genetic defect of the TSH receptors.

Thyroid nodules are a very common phenomenon, occurring with almost 50% of the world's population, but the risk is increased with the presence of certain factors, including:

Heredity:
This is especially true if the condition has occurred in a parent or a sibling.

Age:
The risk is greater as one grows old, and sometimes considered a normal aging process.

Sex:
Thyroid nodules develop more commonly in women than men.

Exposure to radiation:
This may be as part of a medical treatment process for a benign condition such as enlarge tonsils or acne, with teenagers and newborns, or as a result of nuclear power plant accidents or weapon testing. All of the above types of radiation exposure increase the risk of developing nodules.

Certain thyroid conditions:
These include thyroiditis, a chronic inflammation of the thyroid that increases the risk of nodule formation.

Complications

Complications:

Usually nodules are benign, but they begin to cause serious complications, especially the large ones or multinodular goiter that causes breathing and swallowing difficulties. The most serious case is when the nodules start producing thyroid hormones and cause hyperthyroidism.

Besides muscle weakness, unintended weight loss, intolerance towards heat, anxiousness or irritability, there are other complications of hyperthyroidism that might include:

Heart related complications:
Such as rapid heart rate; atrial fibrillation, which is a heart rhythm disorder; and congestive heart failure, which is inability of the heart to pump enough blood to the body due to its weakness.

Osteoporosis:
The excess thyroid hormones may disrupt calcium incorporation into the bones depriving them from an important component that grants their strength. This is one of the effects of the condition which starts developing before any other symptom, especially for postmenopausal women who already have a high risk of osteoporosis.

Thyrotoxic crisis:
This is the sudden elevation of symptoms, which is a potentially fatal condition, thus needs immediate emergency medical care.

Treatments:

Watchful waiting:
If benign thyroid nodules are detected by a biopsy, a physician should observe the condition through periodic thyroid function tests along with physical examination; this is the case when the nodule doesn’t change in size, and treatment may not be needed. Should any enlargement occur, the patient should undergo another biopsy. This is where patient preferences may take part in the course of treatment.

Thyroid hormone suppression therapy:
This is carried out to treat a benign nodule with synthetic thyroxine in the form of pills, such as levothyroxine. The drug acts in the following manner: as the level of thyroxine is increased, the pituitary gland is signaled to decrease the production rate of TSH, thus keeping the thyroid from growing further.
This is a matter of dispute, since no evidence is presented about the effectiveness of the method or even the necessity of treating small, benign nodules.

Radioactive iodine:
Taken in the form of a capsule or liquid to treat hyperfunctioning adenomas or multinodular goiters; when absorbed in the thyroid, it causes the shrinkage of the nodules, where symptoms are diminished within two or three months. As the nodules are destroyed, thyroid hormones are released in the blood stream, which in rare cases causes the deterioration of symptoms from a few days time to a week, along with tenderness in the neck and sore throat. Some patients experience hypothyrodism due to considerable thyroid activity reduction as the result of this therapy.

Surgery:
This is the usual treatment for cancerous nodules where they are surgically removed along with most of the thyroid. Sometimes, even benign nodules are surgically removed due to their large size, which cause difficulties breathing and swallowing. Same as in the case of multinodular goiters, where nodules apply pressure on airways, the esophagus or blood vessels. Indeterminate or suspicious nodules are also removed for biopsy.

Surgery is accompanied with the risk of damage to the nerve connected to the vocal cords, and damage to the parathyroid glands, which are in charge of regulating calcium levels in the blood. Due to the removal of the thyroid, the patient should compensate the absence of hormones by levothyroxine for the rest of his/her life.

Prognosis:

Not Available

Expert's opinion

Expert's Name:
Certificate:
Specialty: -

Expert's opinion:

For Specialists

Clinical Trials:

Not Available

 

Latest Drugs:

--

 

Resources:







Forgot your password


sign up

Consultants Corner

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist
Poll

Which of the following you are mostly interested in?

Cancer Research
Mental Health
Heart Disease & Diabetes
Sexual Health
Obesity and Healthy Diets
Mother & Child Health

Disclaimer : This site does not endorse or recommend any medical treatment, pharmaceuticals or brand names. More Details