Thyroid gland neoplasms (nodes)
Summary/Definition
Neoplasms, so-called “nodules”, form in the thyroid tissue for various reasons. Nodes can vary in size from a few millimetres to several centimetres. The formation of nodules is a common phenomenon, characteristic of almost 5% of all people living on the planet. In most cases, nodules found in the thyroid gland are not malignant tumours but benign (90-95%). The benign formations in the thyroid gland do not interfere with its basic functions. It happens that the nodule does not bother the patient, and he does not feel the signs of the disease, in such cases, the nodule itself does not cause any special harm to human health, except when the neoplasm increases in size so much that it begins to press on the surrounding areas of tissue, causing painful sensations. The causes of thyroid nodules are varied, but most are benign, including colloid nodules, follicular adenomas, autoimmune thyroiditis (Hashimoto’s thyroiditis), cysts (benign cystomas) and others. A nodule in the thyroid gland is formed during the active proliferation of tumour cells, which create many other cells with the same characteristics, from which the nodule is formed. Environmental factors are thought to influence cell proliferation, so iodine deficiency or exposure of the human body to radiation or toxic stimuli can lead to thyroid neoplasms. A more precise mechanism of nodule formation has not yet been learnt.
Symptoms
Usually, thyroid gland neoplasms do not cause any painful sensations in patients, often pathological processes can develop for a long time without any symptoms. It is not unusual that thyroid nodules are discovered accidentally, and since most of them are benign, they grow very slowly and do not spread to other places. Cases when there is bleeding inside the node, or the node suddenly enlarges and becomes painful, and also, increasing in size, can press on the surrounding tissues so much that the patient may experience a feeling of squeezing, up to shortness of breath or difficulty swallowing, are very rare.
Diagnostics
Diagnostics of the thyroid gland include blood tests for thyroid hormones; thyroperoxidase antibodies; scintigraphy and ultrasound of the thyroid gland to determine its functionality, as well as the size and shape of nodules. If a nodule is detected in the thyroid gland through palpation and ultrasound examination, “Fine-needle aspiration biopsy/FAB” is performed to exclude the malignant nature of the neoplasm. This procedure is the collection of cells and cystic fluid from a thyroid nodule for diagnosis using a very fine needle. To diagnose the benignity or malignancy of thyroid nodules, computed tomography and magnetic resonance imaging, cytological and biopsy examination of the thyroid gland are also performed. The results of almost 50-60% of all diagnosed cases show that the neoplasm is benign, this indicates that in such a case the probability of developing a malignant tumour is very low. Even if the neoplasm is large, there are no painful sensations, no special treatment is required, and observation of the dynamics without surgical intervention is carried out. Only 5% of all diagnostic tests reveal malignant tumours in the thyroid gland. At the same time, the most common type of thyroid cancer is papillary cancer, if detected, surgical removal of the neoplasm is recommended. It should be taken into account that in about 10-20% of all diagnostic tests, inaccurate results may be obtained, based on which, unfortunately, it is difficult to distinguish a malignant tumour from a benign mass.
Treatment and course of the disease
The treatment of thyroid nodules depends on the results of the main diagnostic method of its examination – fine-needle aspiration biopsy (FAB). If thyroid nodules are determined to be malignant and cancer is suspected, the malignant tumour is surgically removed. If the diagnostic results are comforting and the nodules are benign, then no surgical intervention is required, it is enough to start monitoring them, checking regularly, every 6-12 months, the condition of the thyroid gland, and undergoing appropriate examination and ultrasound. Also in cases where there is no need for surgical treatment, attempts are made to reduce the size of the node through medication – normalising the level of thyroid hormones. It should be borne in mind that it is not always possible to achieve complete disappearance of the formed node, and to reduce its size takes a long time.
