Xiao Li is 25 years old this year. The handsome young man just entered the company and received the company's first welfare physical examination. The physical examination included a thyroid B-ultrasound. After the examination, it was discovered that there was a 1.0cm nodule on th

Xiao Li is 25 years old this year. The handsome young man just entered the company and received the company's first welfare physical examination. The physical examination items included thyroid B-ultrasound. After the examination, it was discovered that there was a 1.0cm nodule on the right side of thyroid . Does

need surgery? Xiao Li checked all the analyzes on the Internet. Some people said that it can be observed, while others said that thyroid cancer cannot be ruled out, and it was recommended that it must be surgically removed.

Goiter

What kind of thyroid nodules need surgical removal?

With the clinical application of high-resolution B ultrasound , the probability of detecting thyroid nodules is getting higher and higher. Although the prevalence of thyroid nodules is high, not all thyroid nodules require surgical removal.

Most thyroid nodules are benign and can be treated without surgery, but about 5%-15% have a probability of being malignant and require timely surgical removal.

Generally speaking, there are three situations where thyroid nodules require surgery:

1. Thyroid nodules are considered to be cancerous

including the following situations:

① If the thyroid B-ultrasound describes: unclear boundaries, adhesion to surroundings, and low solidity Echogenic masses, calcified nodules, border calcifications, accompanied by lymphadenopathy , and TI-RADS classification of grade 4 or above.

② Physical examination revealed that the thyroid nodule was enlarging rapidly, with the diameter growing to more than 3mm in half a year.

③ Young men or elderly patients with thyroid nodules;

④ There are thyroid cancer patients in the family.

In the above four cases, if the thyroid gland is diagnosed to be cancerous or has a tendency to become cancerous, direct surgical removal is recommended. In the case of Xiao Li in the above example, the result of surgery was also malignant.

Thyroid cancer illustration

2. Large thyroid nodules cause neck compression symptoms

This is the main reason why most people treat thyroid tumors in clinical practice. Many patients find neck swelling and pain, difficulty in swallowing , feeling of foreign body swallowing, and hoarseness, come to see a doctor.

① Neck swelling and pain are mostly caused by internal bleeding of thyroid nodules, which causes nodules and to suddenly enlarge, followed by painful symptoms;

② Foreign body sensation after swallowing is mainly caused by enlargement of thyroid nodules and oppression of the esophagus, and some are caused by Caused by compression of the trachea and deviation;

③ Hoarseness is mainly caused by thyroid nodules compressing the recurrent laryngeal nerve. Of course, it does not rule out that malignant transformation of thyroid nodules invades the nerve.

Thyroid palpation

3. Thyroid nodules combined with hyperthyroidism or high-functioning adenoma

In clinical patients, about 10% of patients with thyroid nodules will develop hyperthyroidism or high-functioning thyroid adenomas, causing symptoms of hyperthyroidism, such as easy Hungry and overeating, weight loss, heart palpitations , hand shaking, abdominal pain, excessive sweating and other symptoms.

Surgical treatment is also recommended for thyroid nodules with comorbidities. Simply taking medicine to treat hyperthyroidism is not satisfactory, and it is easy to relapse after stopping the medicine.

Summary:

Although most thyroid nodules do not require surgery, you must remember to follow up and review the B-ultrasound. If the thyroid nodule shows signs of rapid growth, it must be surgically removed in time.

Of course, even if it is thyroid cancer, you don’t need to worry too much. The vast majority of thyroid cancer patients can achieve long-term survival after standard treatment and rational use of medication after surgery!