Thyroid Nodules (cont.)

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What is the treatment for thyroid nodules?

Follicular adenomas are difficult to distinguish from follicular cancers. Follicular nodules, other nodules highly suspicious for cancerous and definite cancer should be treated by surgery. Most thyroid cancers are curable and rarely cause life-threatening problems. Any nodule not removed needs to be watched closely by follow-up with the physician every 6 to 12 months. This follow-up may involve a physical examination, ultrasound examination, or both. Occasionally, a physician may attempt to shrink the nodule by using suppressive doses of thyroid hormone. Some physicians believe that if a nodule shrinks on suppressive therapy, it is more likely to be benign. If the nodule continues to grow regardless of suppressive therapy, surgery should be considered strongly. The value of suppressive therapy, however, is controversial.

If a nodule causes hyperthyroidism, it is usually noncancerous. Treatment is aimed at preventing the signs, symptoms, and complications of hyperthyroidism, such as heart failure, osteoporosis,, and rapid heart rate. Treatments include destroying the gland using radioactive iodine (131-iodine), blocking production of thyroid hormone with medications, or conservatively following the patient with mild hyperthyroidism. "Subclinical hyperthyroidism" refers to an adult patient with a hyperfunctioning nodule, but TSH is minimally suppressed and the blood levels of thyroid hormones are normal. Treatment is individualized based on age, presence of other medical conditions, and patient preference.

REFERENCE: UpToDate. Patient information: Thyroid nodules (Beyond the Basics).

Previous contributing author and editor: Ruchi Mathur, MD, FRCP(C) and Jay W. Marks, MD


Medically Reviewed by a Doctor on 7/3/2013

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