A thyroid lump (or thyroid nodule) is a lump located in the thyroid gland. Most of the time, this nodule is painless and does not cause symptoms. It is often discovered by chance during a palpation of the neck or an imaging examination. Nodules are very common in the general population (up to 50% of people on ultrasound)especially in women, and their frequency increases with age, indicates the High Authority of Health. Can it develop into cancer? How to treat it?

What is the definition of a thyroid nodule?

The nodule is a small mass located on the thyroid while a goiter concerns the entire thyroid gland which is in this case increased in volume. Thyroidgland located under the Adam’s apple at the base of the neck, in front of the trachea, synthesizes thyroid hormones, T3 and T4, essential to the regulation of the most important functions of the body: regulation of heart rate, body temperature, digestive tract, nervous system, genital system. The hormones produced are synthesized from iodine from the diet. 5 to 20% of the population has a thyroid nodule measuring more than 1 cm and can be observed during palpation. They are about 4 times more common in women.

Can a thyroid nodule develop into cancer?

In at least 90% of cases, the nodules are benign and, after an assessment, only require simple monitoring. The discovery of a nodule requires, without urgency, a consultation with your attending physician which will collect some useful information for the exploration of this nodule. He will question you, in particular about your history, feel your neck to determine the characteristics of the nodule (hardness, mobility, size) and look for abnormal lymph nodes. At this stage, a blood test to measure thyroid stimulating hormone (TSH) and an ultrasound of the thyroid will be requested. The ultrasound will make it possible to explore the thyroid, to determine the location of the nodules, their size, their characteristics and to possibly identify an aspect suggestive of cancer (very rare). In 5 to 10% of cases, the nodules may correspond to cancer. These are generally cancers with a good prognosis, not very aggressive, with a slow evolution.

There are several types of thyroid nodules.

• THE colloidal nodule represents the most common form and consists of normal cells.
• THE cysts, mostly benign, are fluid-filled formations up to several centimeters in diameter. An inflammatory nodule may appear most often in people with thyroiditis.
• The nodule may also be linked to a adenomaa benign, slowly growing tumour.

What are the symptoms of a thyroid nodule?

“The vast majority of thyroid nodules cause no symptoms. Most being discovered during an ultrasound of the neck, more rarely during palpation of the neck by the doctor during a consultation“, explains Doctor Scheimman, endocrinologist If the nodule produces too much thyroid hormoneit is then manifested by signs of hyperthyroidism: weight loss, heart palpitations, sleep disturbances, muscle weakness, diarrhea, nervousness or irritability.

Who are the people at risk? The women ?

• Women 3 times more exposed to thyroid nodules only men.
• The elderly because the nodules become more frequent from the age of 60.
• People with iodine deficiency
• People who have a close relative with a thyroid nodule and who have already had a thyroid abnormality
• People who have already received radiation therapy to the head or neck
• People who have been exposed to radioactive particles linked to nuclear tests or nuclear accidents (Chernobyl, Fukushima, etc.) are also at greater risk.

When to consult?

You should consult your doctor:

• before the appearance of a small, visible or palpable abnormal mass on the front of the neck,
• in case of breathing or swallowing difficulties,
• in the presence of a swollen glands located at the neck
• at the time of appearance of weight loss when the appetite is normal,
• palpitations, tremors, insomnia, nervousness testifying to signs of hyperthyroidism.
• before pain or pressure radiating to the neck

What is the treatment for a thyroid nodule?

Treatment for thyroid nodules depends on the nature of these nodules. “In the majority of cases, when ultrasound is reassuring, simple clinical and biological monitoring with TSH assay is sufficient.“, indicates our interlocutor.

When should a thyroid nodule be punctured?

In the majority of cases, we do not touch a benign nodule, if it has a size of less than 4 cm. If it is troublesome on a daily basis or very large, especially if it is located on the thyroid gland, you may still have to remove itto prevent it from hindering swallowing.

Thanks to Doctor Alain Scheimann, endocrinologist and author of What if it was the thyroid? (In Press, 2017)

Source : Thyroid nodule – How to explore it?, HAS, September 28, 2021