Thyroid Nodules: Concerns and Follow-Up Questions

Thyroid gland measures 0.46 x 0.31 cm in the anteroposterior dimension and 0.6 cm in the transverse dimension?

Hello Doctor, I recently had an ultrasound examination that found a left thyroid nodule measuring approximately 0.6 cm in an oblique angle, with dimensions of 0.46 cm (width) x 0.31 cm (height).
After a follow-up in about four months, there hasn't been much change.
However, the doctor is concerned because the nodule has unclear margins (no calcification), which makes me very anxious.
In October of this year, I had a cold with a sore throat, but the discomfort in my throat has only lessened and has not completely disappeared, lasting for over two months.
The discomfort is primarily on the left side, affecting my cheek, teeth, inner ear, and throat.
I have three questions for the doctor: 1.
Could this be caused by the thyroid? 2.
Although everyone says that 95% of thyroid nodules are benign, what is the actual risk of malignancy if the margins are unclear? 3.
Is there a chance that a biopsy will be performed? Thank you for your response, Doctor.

CH, 40~49 year old female. Ask Date: 2022/12/26

Dr. Yuan Tianmin reply Breast and Thyroid

On the contrary, I believe that this type of cold may actually cause the enlargement of thyroid nodules.
However, for a definitive assessment, please consult a thyroid specialist for an examination.

Reply Date: 2022/12/26

More Info

Understanding thyroid nodules can be a source of anxiety for many patients, especially when there are concerns about their characteristics and potential implications for health. Based on your description, you have a thyroid nodule that measures approximately 0.6 cm with unclear borders, and you are experiencing persistent discomfort on the left side of your throat and face. Let’s address your questions one by one.

1. Could this be caused by the thyroid nodule?
While thyroid nodules can sometimes cause discomfort, especially if they are large or pressing against surrounding structures, it is less common for small nodules (like yours at 0.6 cm) to cause significant symptoms. The discomfort you are experiencing in your throat, face, and ear could be due to several factors, including inflammation, infection, or even referred pain from another area. Given that you had a recent upper respiratory infection, it is possible that your throat discomfort is related to that rather than the nodule itself. However, it is essential to discuss these symptoms with your healthcare provider, as they can perform a thorough examination and possibly recommend further evaluation.

2. What is the risk of malignancy with unclear borders?
It is true that the vast majority of thyroid nodules (approximately 95%) are benign. However, the characteristics of a nodule, including its borders, composition, and whether it contains calcifications, can influence the risk of malignancy. Nodules with unclear or irregular borders may raise suspicion, but this does not automatically mean they are malignant. The actual risk of a nodule being cancerous can vary based on several factors, including your age, gender, family history, and any associated symptoms. Generally, the risk of malignancy in nodules that are less than 1 cm and have benign features is relatively low, but it is crucial to follow up with your healthcare provider for personalized risk assessment.

3. Is a biopsy necessary?
The decision to perform a fine-needle aspiration (FNA) biopsy depends on several factors, including the size of the nodule, its ultrasound characteristics, and your clinical history. In many cases, nodules that are smaller than 1 cm and have benign features may not require immediate biopsy, especially if they are being monitored with regular ultrasound follow-ups. However, if the nodule shows concerning features (such as unclear borders) or if there are changes in size or characteristics over time, your doctor may recommend a biopsy to rule out malignancy. It is essential to have an open discussion with your endocrinologist or healthcare provider about your concerns and the best course of action for your specific situation.

In summary, while your thyroid nodule is small and the likelihood of it being malignant is low, the unclear borders warrant careful monitoring. Your throat discomfort may not be directly related to the nodule, but it is essential to keep your healthcare provider informed of all your symptoms. Regular follow-up and communication with your healthcare team will help ensure that any changes are addressed promptly. If you have further concerns or if your symptoms persist, do not hesitate to seek a second opinion or further evaluation. Your health and peace of mind are paramount.

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