The thyroid gland sits in the front part of the neck below and overlying the larynx or voice box. It secretes hormones that help regulate overall body metabolism and maintain calcium balance in the body. A common disorder of the thyroid is formation of a nodule. These can be solitary or multiple and may be solid or fluid-filled (cystic). Some nodules contain thyroid cancer but even benign ones can grow large enough to compress the trachea (windpipe) and/or esophagus (swallowing tube) causing difficulty breathing or swallowing. Fortunately the majority of thyroid nodules are noncancerous but the chance of a thyroid cancer is high enough that nodules should be addressed.

Evaluation usually includes a blood test to determine the overall level of thyroid gland hormone production. A thyroid ultrasound scan is almost always done to assess the size, location, consistency of the nodule(s), and relationship to nearby structures. A needle biopsy is frequently performed to obtain cells for analysis and this may be done in conjunction with ultrasound to improve the accuracy of the biopsy. The results of these various tests should lead to a diagnosis and a recommendation for treatment if any is needed. Sometimes surgery is needed to remove the nodule because either the tests were inconclusive or they indicated a suspicion of cancer. Space does not permit a thorough discussion of all of the possibilities but there are many factors that have to be taken into consideration when deciding how to deal with a lump in the thyroid. The physicians at Capitol Ear, Nose, and Throat are happy to work with you, your primary physician, and/or an endocrinologist to help you reach a correct diagnosis and treatment plan should you ever develop this common condition.

Posted by Steven H. Dennis, MD