Thyroid Nodules: When to Seek Medical Advice

Goiter

Hello Doctor: I have a soft mass about 1.5 cm in size on the right side of my thyroid gland that moves up and down when I swallow.
It has not changed in size or hardness for the past 13 years, and I have no other discomfort.
I have only had a physical examination and have not undergone any ultrasound or biopsy.
Blood tests have shown no signs of hyperthyroidism or hypothyroidism.
However, I am a bit worried since some friends around me have been diagnosed with thyroid cancer.
Do you think I need to go to the hospital for further examination? Also, should I see an endocrinologist or an otolaryngologist? Thank you.

LULU, 40~49 year old female. Ask Date: 2023/04/15

Dr. Zheng Jueyi reply Otolaryngology

If you are concerned, it is advisable to undergo an ultrasound examination.
Since different hospitals may have varying departments that perform neck ultrasounds, you can first schedule an appointment with a department that offers ultrasound services, such as the Department of Metabolism, Otolaryngology, or General Surgery for evaluation.

Reply Date: 2023/04/15

More Info

When it comes to thyroid nodules, it is essential to understand when to seek medical advice and what steps to take for proper evaluation. Based on your description, you have a soft, movable nodule on the right side of your thyroid that has remained stable in size and consistency for 13 years. While this is reassuring, it is still prudent to follow up with appropriate medical evaluations, especially given your concerns about thyroid cancer.

When to Seek Medical Advice:
1. Changes in Size or Consistency: If you notice any changes in the size, shape, or firmness of the nodule, it is crucial to seek medical advice. Rapid growth or hardening of the nodule can be concerning.

2. Symptoms: If you experience symptoms such as difficulty swallowing, hoarseness, or any signs of thyroid dysfunction (like changes in weight, energy levels, or temperature sensitivity), you should consult a healthcare provider.

3. Family History: A family history of thyroid cancer or other thyroid disorders can increase your risk, warranting closer monitoring.

4. Duration: Although your nodule has been stable for 13 years, any persistent nodule, especially in the context of recent concerns about thyroid cancer among peers, should be evaluated.

Recommended Evaluations:
- Ultrasound: This is the first-line imaging study for evaluating thyroid nodules. It helps assess the characteristics of the nodule, such as its size, composition (solid vs. cystic), and vascularity. Ultrasound can also identify any additional nodules that may not be palpable.

- Fine Needle Aspiration (FNA) Biopsy: If the ultrasound shows features that are concerning for malignancy (such as microcalcifications, irregular margins, or increased vascularity), an FNA biopsy may be recommended to obtain a sample of the nodule for cytological analysis.

Which Specialist to See:
For your situation, you should consider seeing an endocrinologist who specializes in thyroid disorders. They can provide comprehensive care, including the necessary imaging studies and any further evaluations. An ear, nose, and throat (ENT) specialist may also be involved, especially if there are concerns about the nodule affecting surrounding structures or if surgical intervention is needed.

Conclusion:
While your nodule has been stable and asymptomatic for many years, it is wise to pursue further evaluation to ensure that there are no underlying issues. An ultrasound and possibly an FNA biopsy will provide valuable information about the nature of the nodule. Given your concerns about thyroid cancer, it is better to err on the side of caution and seek medical advice. Regular monitoring and appropriate imaging can help alleviate your worries and ensure your thyroid health is maintained.

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