Very often, nodules produce no symptoms. Doctors will find thyroid nodules only during a routine physical exam or imaging tests that are done for another reason. However, thyroid nodules that are big enough to feel during a physical exam occur in a few people.
If the doctor finds a nodule or you have symptoms of a nodule, the following tests may be done:
Causing symptoms such as swallowing or breathing problems
Due to thyroid cancer
Not able to be diagnosed as cancer or not cancer
Patients with nodules that are making too much thyroid hormone may be treated with radioactive iodine. This treatment reduces the size and activity of the nodule. Pregnant women should not be given this treatment.
Both surgery to remove thyroid gland tissue and radioactive iodine treatment carry risks of long-term thyroid problems.
For noncancerous nodules that do not cause symptoms and are not growing, the best treatment may be:
Careful follow-up with a physical exam and ultrasound
A thyroid biopsy repeated 6 - 12 months after diagnosis, especially if the nodule has grown
Another possible treatment is ethanol (alcohol) injection into the nodule to shrink it.
Noncancerous thyroid nodules are not life threatening. Many do not require treatment. Follow-up exams are enough.
The outlook for thyroid cancer depends on the type of cancer.
Calling your health care provider
Call your health care provider if you feel or see a lump in your neck, or if you experience any symptoms of a thyroid nodule.
If you have been exposed to radiation in the face or neck area, call your health care provider. A neck ultrasound can be done to look for thyroid nodules.
Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2010;16(suppl 1):1-43.
Kim M, Ladenson P. Thyroid. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 233.
Schlumberger MJ, Filetti S, Hay ID. Nontoxic Diffuse and Nodular Goiter and Thyroid Neoplasia. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 14.
Shehzad Topiwala, MD, Chief Consultant Endocrinologist, Premier Medical Associates, The Villages, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.