Benign thyroid tumor
Summary/Definition
A thyroid nodule is a voluminous tumor, different in density from the rest of the thyroid gland tissue, in which tissue changes are detected during diagnosis. The probability of finding nodules increases with age. When diagnosing the nature of nodules, they can be benign (hyperproliferative, neoplastic processes, colloid nodules, cystic nodules, follicular adenomas, inflammatory formations, etc.) and malignant (papillary, follicular, medullary cancer, etc.). The number of nodular tumors is also differentiated by their number – single or multiple, by the state of thyroid function – nonfunctioning nodule or “cold”, functioning – “hot” nodule, etc.
Symptoms
Usually, thyroid nodules do not show any symptoms, they do not cause any painful symptoms, but in some cases they may increase so much that they squeeze the neck organs, accompanied by swallowing disorders or a feeling of suffocation. That is, such symptoms appear only when the nodes are significantly increased in size. A large node can grow and squeeze the surrounding areas and organs – oesophagus, and vocal cords, causing problems with swallowing, pepper, difficulty breathing or voice change, up to complete loss of voice. A nodule can be detected by palpation of the thyroid gland, as it is easily palpable. Such formations are dense and hard. The dangerous symptom is the simultaneous enlargement of lymph nodes in the neck, which may indicate the probable occurrence of the malignant nature of the node.
Diagnostics
As we know, 90-95% of thyroid nodules are benign, and most of them, when diagnosed, do not even require special treatment. However, it should not be forgotten that if the detected nodule is malignant, immediate treatment is required. The nodes according to the properties of hormone production are divided into non-functioning and functioning. To assess the condition and determine the function of the thyroid gland, the concentration of hormones produced by it in the blood is measured, as well as the dynamics and hereditary factors in the development of the disease. To exclude the fact of the presence of autoimmune diseases of the thyroid gland, a test for antibodies to thyroperoxidase is carried out. To determine the size of the tumor in the thyroid gland, scintigraphy is carried out to check whether the nodule is not too large. The main information about the condition of this organ can be obtained by diagnostic tests ultrasound, magnetic resonance imaging or computed tomography.
Treatment and course of the disease
If after diagnosis it is found that the majority of benign nodules in the thyroid gland are non-functioning tumors, the prognosis for the patient is favourable and no special treatment is required. If there are functioning nodules, a complete cure of the patient is possible only with appropriate specialised treatment.
The nodules in the thyroid gland are treated with different methods depending on the benignity or malignancy of the tumor. If the diagnosis by fine-needle aspiration biopsy reveals malignancy of the nodule, surgical intervention is required. In most cases, when benign nodules are detected, patients have no pain or complaints, so no separate treatment or surgery is required, just regular monitoring. At the same time, there are situations in which the size of the formation, despite its benignity, causes cosmetic and physiological problems, pressing on the neck and neighbouring organs, making it difficult to breathe or swallow food, in such cases surgical intervention is required. The non-surgical treatments include ethanol sclerotherapy and radiofrequency ablation.
The treatment of non-functioning benign nodules includes suppressive therapy with thyroid hormones (T4 – thyroid hormone), treatment of cysts, cystic nodules and cysts, and radiofrequency ablation under ultrasound control. Most functioning benign tumors in the thyroid gland are not dangerous in most cases, constant monitoring and regular check-ups are enough, as the probability of developing cancer is very low. In such cases, there is no drug treatment, but if necessary, surgical treatment or invasive treatment methods may be prescribed: radioiodotherapy, ethanol sclerotherapy, and radiofrequency ablation.
