Health

When do goiters need surgery? – VnExpress


A goiter is usually benign, but if it is large, causing compression, swallowing problems, choking, even difficulty breathing, surgery may be needed to remove it.

I have had goiter for 5 years now. At first the tumor was small, I didn’t see any problem, so I didn’t take medicine, but now it’s the size of a plum. Recently, I feel a lump in my neck, feeling a little choking when I swallow. I am worried that the tumor has grown large enough to require surgery. Please ask the doctor if my case is necessary to have surgery or can take medicine to shrink the tumor. Can a goiter turn into cancer? (Kim Anh, Kien Giang)

Reply:

There are many different causes of an enlarged thyroid gland (goiter or goiter) or nodules in the thyroid gland. The most common causes of goiter are iodine deficiency, goiters found in foods, thyroid deficiency enzymes (gene defects) that synthesize thyroid hormones, autoimmune thyroid diseases, thyroid gland is exposed to x-rays in childhood, thyroid gland is exposed to radioactive substances… These causes can be simple enlargement of the thyroid gland (diffuse goiter), or enlargement of the thyroid gland accompanied by nodules, or form nodules without enlargement of the thyroid gland.

Thyroid nodules, of which the majority are benign, only about 5% are malignant. However, large goiters, fast-growing goiters, goiters in the elderly, goiters in men also have a higher risk of cancer.

Doctors appoint surgery for cases of thyroid nodules that are cancerous, or those that are suspected of cancer. Cases of benign large goiter, with symptoms of compression causing difficulty swallowing, difficulty swallowing, even difficulty breathing, also need surgery. There are cases where a large goiter does not cause compression, but because of cosmetic problems, the goiter can also be operated on.

Many cases of goiter, nodular goiter are benign but do not need surgery. These cases may only need treatment with thyroid hormone, even without treatment, but only need periodic monitoring about every 3 – 6 months. Hyperthyroidism with large goiter is treated with antithyroid drugs, later surgery or radioactive iodine treatment when the disease is stable and the goiter is too large.

An ultrasound patient checks his thyroid gland at Tam Anh General Hospital. Image: Hospital provides

In order to accurately determine whether the goiter requires surgery or not, the patient should go to the hospital specializing in endocrinology for examination and appropriate indications. The specialist doctor, in addition to the clinical examination, also appoints blood tests to evaluate thyroid function, thyroid ultrasound to determine the size of the goiter, evaluates the risk of malignancy of the tumor, and cytology of the tumor. Tumor… The doctor will also advise the patient whether to remove the thyroid nodule alone, or remove a lobe of the thyroid gland, cut nearly the whole or remove the entire thyroid gland. Currently, there is a method of treating benign nodular goiter by high-frequency ablation without scarring, with few complications, patients only feel numbness in the neck area.

Going back to your specific case, your goiter is also growing relatively quickly and there are signs of esophageal compression. It is appropriate to consider surgical removal of the goiter. However, you should go to the hospital for an accurate pre-operative assessment to see if your goiter is just a benign tumor causing compression or a malignant tumor that has invaded, metastasized or not,… for the surgery. success. Wish you health!

TTTT.TS.BS Hoang Kim Uoc
Head of the Department of Endocrinology – Diabetes, Tam Anh General Hospital, Hanoi

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