Thyroid Nodules

Question 1

Define Thyroid Nodules?

Answer 1

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

Question 2

What is the aetiology of Thyroid Nodules?

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

What is the epidemiology of Thyroid Nodules?

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

What are the presenting symptoms of Thyroid Nodules?

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

What are the signs of Thyroid Nodules 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

What investigations do you do for Thyroid Nodules?

Answer 6

TFTs - most patients will be euthyroid
US - 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