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Thyroid nodule - Treatment

Alternative Names

Thyroid tumor; Thyroid adenoma; Thyroid carcinoma; Thyroid incidentaloma

Treatment:

Your health care provider may recommend surgery to remove all or part of your thyroid gland if the nodule is:

  • Cancerous
  • Believed to be making your thyroid overactive (hyperthyroid)
  • Cannot be diagnosed as cancer or noncancer
  • Cause symptoms such as swallowing or breathing problems

Patients with overactive nodules may be treated with radioactive iodine, which reduces the size and activity of the nodule. However, in rare cases the treatment can cause hypothyroidism and inflammation of the thyroid gland (radiation-induced thyroiditis). Pregnant women should not be given this treatment. Women being treated with radioactive iodine should not get pregnant.

Levothyroxine (thyroid hormone) is a drug that suppresses the production of the thyroid hormone T4. A doctor may prescribe levothyroxine to treat noncancerous nodules only in special cases.

Careful follow-up is the only recommended treatment for benign nodules that do not cause symptoms and are not growing. A thyroid biopsy may need to be repeated 6 - 12 months after diagnosis. An ultrasound may be repeated as well.

Other possible treatments include ethanol (alcohol) injection into the nodule and laser therapy.

Expectations (prognosis):

Noncancerous thyroid nodules are not life threatening. Many do not require treatment, only follow-up. Noncancerous nodules that do need treatment have an excellent outlook.

The outlook for cancerous nodules depends on the type of cancer.

See also: Thyroid cancer

Complications:

Hyperthyroidism is a common complication of noncancerous thyroid nodules.

Complications of treatment can include:

  • Hoarse voice if vocal cord nerves are damaged during surgery
  • Hypothyroidism from surgery or radioactive iodine therapy
  • Low blood calcium (hypocalcemia) from hypoparathyroidism if parathyroid glands are accidentally damaged or removed during surgery

Calling your health care provider:

Call your health care provider if you feel or see a lump in your neck, or if you experience any symptoms of a thyroid nodule.

If you have been exposed to radiation in the face or neck area, call your health care provider. A neck ultrasound can be done to look for thyroid nodules.

  • Reviewed last on: 4/19/2010
  • Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Gharib H, Papini E, Valcavi R, et al.; AACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2006;12:63-102.

Schlumberger MJ, Filetti S, Hay ID. Nontoxic Diffuse and Nodular Goiter and Thyroid Neoplasia. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 13.

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