Dr Bashar Saleh
BAHRAIN SPECIALIST HOSPITAL
A Vexing Condition The lifetime risk for developing a palpable thyroid nodule is estimated to be five to 10 per cent, and the condition affects more women than men.
The term ‘thyroid nodule’ refers to any abnormal growth that forms a lump in the thyroid gland. A nodule can occur in any part of the gland, which is located in the front of the neck, below the Adam’s apple. Some can be felt quite easily; others can be hidden deep in the thyroid tissue or located very low in the gland, where they are difficult to find. Dr Bashar Saleh, consultant general and laparoscopic surgeon at Bahrain Specialist Hospital explains the condition and its treatment methods. Types of thyroid nodules Thyroid nodules may be single or multiple. A gland that contains multiple nodules is referred to as a multinodular goitre. If the nodule is filled with fluid or blood, it is called thyroid cysts. When the nodule produces the thyroid hormone in an uncontrolled manner without regarding the body’s needs, it is referred to as autonomous. This kind may cause signs and symptoms of too many thyroid hormones, or hyperthyroidism. Less often, patients with a thyroid nodule may have too little thyroid hormones, or hypothyroidism. “The most common types of single thyroid nodules are noncancerous colloid nodules or follicular adenomas. Few nodules are cancerous; they are classified by the types of malignant thyroid cells that they contain. The prognosis for the patient
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depends largely on the cell type and how far the cancer has spread at the time of diagnosis,” the doctor explains. Thyroid nodules may contain lymphoma, a cancer of the cells of the immune system. Cancer from other sites, such as breasts and kidneys, can also spread to the thyroid. The cause of most thyroid nodules is unknown. In certain cases, insufficient iodine in the diet can cause thyroid to develop nodules. Certain genes may contribute to development of thyroid nodules. Treatment methods Follicular nodules, highly suspicious for cancer, should be treated by surgery. Most thyroid cancers are curable and rarely cause life-threatening problems. Any nodule that hasn’t been removed needs to be watched closely by follow up with the physician every six to 12 months. This may involve a physical examination, ultrasound examination or both. Occasionally, a physician may attempt to shrink the nodule by using suppressive doses of thyroid hormones. “Some believe that if a nodule shrinks on suppressive therapy, it is more likely to be benign. If the nodule continues to grow regardless of the therapy, surgery should be considered,” Dr Bashar notes. E Call 17 812-000.
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