The presence of goiter and thyroid nodules does not give rise to specific symptoms, unless the size is such that it causes compression of the trachea or oesophagus, leading to swallowing or breathing disorders.
In 2-5% of nodules are cancer.
Essential to perform an neck ultrasound,by an expert in Endocrine certified physician.
“Suspicious” nodules on ultrasound are identified and an ultrasound-guided needle aspiration biopsy and collection of molecular markers but held until the pathology report.If the result is Suspicious the markers are sent for DNA/RNA.
In the management of goiter and thyroid nodules, a conservative approach tends to be adopted, but in the presence of benign multinodular goiter with compressive effects, the treatment can be done without surgery with ethanol ablation for moostly cystic nodules and radiofrequency ablation RFA for solid nodules
Hyperthyroidism due to toxic or Autonomous functioning thyroid nodules also can be treated without Radioiodine radiation or surgery by RFA.
A small thyroid cancer <1.5 cm in selected cases can be treated without surgery by RFA.
Metastatic thyroid cancer in neck lymph nodes after neck dissection can be RFA ablated in only 3 nodes are found with cancer.
Advanced thyroid cancers recurrent in the central compartment can be treated with RFA instead of radiation or radioiodine but is usually to relieve symptoms only and is rarely curative but just palliative.
A thyroidectomy if needed requires a stay of 2-3 days and recovery time is short, with a return to daily life in about 10 days. This is without complications which can be severe.
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