Thyroid Nodules & Goitre
Lumps and swelling of the thyroid — usually harmless, always worth checking.
What is it
A thyroid nodule is a lump within the gland, while a goitre is an overall enlargement of it. Both are very common, particularly as we get older, and the large majority of nodules are benign rather than cancerous.
Most nodules cause no symptoms at all and are found by chance during a scan done for another reason. Occasionally a nodule is overactive and produces extra thyroid hormone, or grows large enough to cause a sensation of pressure, a visible lump in the neck, or changes to the voice or to
swallowing. Finding a nodule is common; finding one that needs treatment is much less so.
How it is diagnosed
The first step is a neck ultrasound, a painless scan that measures any nodules and assesses their appearance for features that warrant a closer look. Thyroid blood tests are done at the same time to confirm the gland is working normally.
Where a nodule has concerning ultrasound features, a fine-needle aspiration is arranged. This is a quick procedure performed in the clinic using a thin needle to take a small sample of cells, and it is the test that reliably distinguishes benign nodules from the small minority that are not.
How it is managed
Many nodules need nothing more than periodic ultrasound to confirm that they are stable, and a great deal of unnecessary treatment is avoided by simply watching carefully.
An overactive nodule may be treated with medication, radioactive iodine or a procedure, depending on its size and behaviour. Surgery is reserved for nodules that are suspicious or confirmed to be cancerous, and for large nodules causing pressure symptoms.
Whatever the result, we take the time to explain your ultrasound and pathology findings in plain language, so you understand exactly what has been found and what it means. Uncertainty is usually more distressing than the diagnosis itself.
When to seek care promptly
A rapidly growing lump in the neck, new hoarseness, or difficulty swallowing or breathing should be assessed promptly.
Further reading
The American Thyroid Associationls nodule pages (thyroid.org/thyroid-nodules) and the Endocrine Society patient hub (hormone.org) provide further detail.
Speak with our team
Our specialist endocrinologists diagnose and manage this condition every day. Request a consultation with our team today.
