Thyroid Nodule/s

Question 1

Definition

Answer 1

Abnormal growth of thyroid cells that forms a lump in the thyroid gland.

Question 2

Aetiology/Risk factors

Answer 2

· The vast majority of thyroid nodules are BENIGN, but a small proportion turn into thyroid cancer

· Most thyroid nodules are adenomatous and most are multiple

· The nodules are usually non-functioning

Question 3

Epidemiology

Answer 3

· 40% of the general population have a single nodule or multiple nodules

· More common in WOMEN

· Very small proportion of thyroid nodules will be malignant

Question 4

Presenting symptoms

Answer 4

· Most are ASYMPTOMATIC

· Usually found on self-examination or clinical examination

· A single isolated nodule is more likely to be malignant

· They can sometimes cause pain and will rarely compress the trachea or cause dysphagia

Question 5

Signs on physical examination

Answer 5

· Ask the patient to drink some water and see if the nodule moves when swallowing

· Check for regional lymphadenopathy (consider malignancy)

Question 6

Investigations

Answer 6

· TFTs - most patients will be euthyroid

· Ultrasound - useful for determining the character of the thyroid nodules

· FNA - allows cytological analysis

· Radionuclide Isotope Scanning - checks iodine uptake

· CT/MRI - detect spread of thyroid cancer