Most thyroid nodules are benign — but all deserve proper evaluation. Dr. Guttler explains what nodules are, how they are diagnosed, and when treatment is needed.
A thyroid nodule is a lump or growth within the thyroid gland. They are extremely common — found in up to 50% of adults on ultrasound — and the vast majority are benign. However, a small percentage can be cancerous, which is why every nodule deserves a careful evaluation by an experienced thyroid specialist.
A thyroid nodule is an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Nodules can be solid, fluid-filled (cystic), or a mixture of both. They range in size from a few millimeters to several centimeters. Most are discovered incidentally on imaging done for another reason, or felt during a routine neck exam.
Thyroid nodules are remarkably common. High-resolution ultrasound detects nodules in 19–68% of randomly selected individuals, with higher rates in women and older patients. Despite their prevalence, only about 5–10% of thyroid nodules are malignant, making proper evaluation — not panic — the right response.
The cornerstone of nodule evaluation is thyroid ultrasound, which characterizes the nodule's size, composition, and suspicious features. If a nodule has worrisome characteristics or exceeds size thresholds, a fine needle aspiration (FNA) biopsy is performed. Dr. Guttler has performed thousands of FNA biopsies and is a nationally recognized expert in thyroid cytopathology.
Most benign nodules require only periodic monitoring with ultrasound. Treatment is indicated when a nodule is malignant, causes compressive symptoms (difficulty swallowing or breathing), produces excess thyroid hormone (toxic nodule), or grows significantly over time. Radiofrequency ablation (RFA) is now an excellent non-surgical option for many benign nodules.
RFA is a minimally invasive, outpatient procedure that uses heat energy delivered through a needle to shrink thyroid nodules without surgery. Dr. Guttler trained with world leaders in RFA in Italy and Brazil and has been a pioneer in bringing this technique to the United States. RFA can reduce nodule volume by 50–90% with minimal downtime.
Thyroid Nodules: What You Need to Know
Most thyroid nodules are benign, but some require evaluation. Dr. Guttler explains ultrasound, biopsy, and when to consider RFA instead of surgery.
Lecture 4: Goiter & Benign Thyroid Nodules
Most thyroid nodules are benign. Dr. Guttler explains what causes goiters and nodules, how they are evaluated, and when treatment is needed.
Lecture 5: Thyroid Cancer — What Patients Need to Know
A thyroid cancer diagnosis is frightening — but thyroid cancer is among the most treatable of all cancers.