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Solitary thyroid nodules are more common in females yet more worrisome in males. Other associations with neoplastic nodules are family history of thyroid cancer and prior radiation to the head and neck. Solitary thyroid nodules are mostly benign colloid nodules. The second most common type is follicular adenoma. [26]
Further evaluation with ultrasound is required for patients less than 35 years old with nodules measuring more than 1 cm in the axial plane. The cutoff size for further evaluation is raised to 1.5 cm for patients more than 35 years old. This recommendation should be applied to the largest thyroid nodule in cases of multiple thyroid nodules.
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2]
Regular monitoring mainly consists of watching for changes in nodule size and symptoms, and repeat ultrasonography or needle aspiration biopsy if the nodule grows. [8] For patients with benign thyroid adenomata, thyroid lobectomy and isthmusectomy is a sufficient surgical treatment.
If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10] Ultrasound has a sensitivity of 64-77% and a specificity of 82-90% for the detection of thyroid cancer. [10]
The thyroid ultrasound is also very effective to discover microcarcinomas, which refer to very small carcinomas (<1 cm). Papillary thyroid carcinomas are also discovered when a hard nodule is found in multinodular goiter, when enlarged cervical lymph nodes are detected, or when there are unidentified metastatic lesions elsewhere in the body. [5]
Colloid nodules may be initially identified as an unspecified kind of thyroid nodule. Follow-up examinations typically include an ultrasound if it is unclear whether or not there really is a nodule present. Once the presence of a nodule has been confirmed, the determination of the kind of thyroid nodule is done by fine needle aspiration biopsy. [7]
Anaplastic thyroid cancer seen on an ultrasound image Anaplastic thyroid carcinoma cells. ATC is considered an emergency cancer diagnosis since it poses a high risk of blocking the airway and/or esophagus due to its rapid growth in the neck, either of which can quickly cause a person's death by asphyxiation, if not immediately corrected. [2]
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