Common types of thyroid nodules

Thyroid aneurysm, goiter, thyroid cancer… due to endocrine disorders, benign can be self-limited, but malignant needs early treatment.

Goiter (goiter, goiter) is one of the most common thyroid disorders. Most patients have benign thyroid nodules, simple treatment but can also be malignant.

Thyroid bulge

Master, Doctor Tran Nguyen Quynh Tram (Department of Endocrinology – Diabetes, Tam Anh General Hospital in Ho Chi Minh City), 80% of thyroid goiters are benign goiters (medically called simple goiters or goiters). thyroid enlargement). The disease appears with swelling of the thyroid gland, abnormally increased in size. There are many causes of benign goiter such as dietary iodine deficiency; female hormone disorders in puberty, pregnancy, childbirth, perimenopause; due to antithyroid substances; abnormalities in thyroid hormone synthesis; persistent diarrhea; nephrotic…

This disease is more common in women than in men. Benign goiters are silent and difficult to detect in the early stages. Enlarged tumors appear without altering thyroid hormone secretion. When the disease progresses and the tumor grows, the patient easily notices signs such as palpating a tumor in the middle of the neck, with clear boundaries, no sticking to the skin, no pain, moving with swallowing rhythm. When the goiter is large, it can cause uncomfortable compression.

Patients can be examined and tested to diagnose benign or malignant thyroid nodules. Image: Shutterstock

Nodular goiter

A nodular goiter is a benign mononodular or multinodular goiter (multinodular goiter). The patient will notice many round masses from 0.5 cm to a few cm in diameter around the neck. At this time, the patient has a feeling of shortness of breath due to the pressure of the tumor, even difficulty speaking, hoarseness, double voice… when pinching nerves. Facial edema, neck edema, and thoracic distension due to tumor compression of the vena cava may also be present.

According to Dr. Tram, goiter is benign and self-healing in some patients. When the tumor has nuclei, the most optimal method of treatment is to use surgery. The earlier the disease is detected, the more effective the surgery is. People with thyroid enlargement or nodular goiter are compressed in the neck depending on the size and location of the goiter. Among people with goiter, about 5-10% of cases are malignant.

Thyroid Cancer

Dr. Tram further shared, thyroid cancer occurs in 5-10% of patients with thyroid nodules. It is caused by abnormal cell division of the thyroid gland. Two types of cancer, papillary and follicular differentiated thyroid cancer, account for about 90% of thyroid cancers. The early signs are like a common goiter, so it is easy to miss.

If thyroid cancer is detected, the patient needs to have surgery soon. Ultrasound will show solid nodules, lymph nodes, calcifications… If in doubt, the doctor will perform a fine-needle biopsy (FNA). Treatment of thyroid cancer with radioactive iodine, laparoscopic or open surgery.


Hyperthyroidism occurs when the thyroid gland produces too much hormone. This excess can have a number of causes, including thyroiditis or Graves’ disease (diffuse toxic goiter). Hyperthyroidism occurs causing a variety of symptoms including a fast or irregular heartbeat; difficulty sleeping; irritability and anxiety; tired; hot; frequent bowel movements, diarrhea; thin weight loss, enlarged thyroid (big neck).

If left untreated, Graves’ disease can cause severe thyrotoxicosis, where life-threatening thyrotoxicosis (thyroid storm) occurs. Prolonged severe thyrotoxicosis leads to severe weight loss with skeletal and muscle catabolism, cardiac complications, and psychiatric complications. Graves’ disease is also associated with eye, skin, and white blood cell problems.

Thyroid storm is an exaggerated state of thyrotoxicosis. It usually occurs in patients with undetected or inadequately treated thyrotoxicosis or a precipitating event such as thyroid surgery, non-thyroid surgery, infection, or trauma. Dr. Tram said that now with active therapy and early recognition of the syndrome, the death rate from thyroid storm is only 20%.

Treatments for hyperthyroidism include medical treatment with drugs, radiation therapy by taking radioactive iodine, or surgical treatment with thyroid surgery.

The opposite of hyperthyroidism is hypothyroidism, which occurs when the thyroid gland does not produce enough hormones. This is the most common thyroid disorder, which can cause processes in the body to slow down. Symptoms of hypothyroidism include fatigue, fear of cold, dry skin, slow heart rate, cramps, constipation, weight gain…

Treatment for hypothyroidism is usually thyroid hormone supplementation to control symptoms. If hypothyroidism is not treated early, it will cause cardiovascular effects and infertility.

Nha Trang


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