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What Causes Visible Swelling On Neck While Suffering From Hypothyroidism?
Question: I am a 47 yo female. I have hypothyroidism and take synthroid 88mcg daily. I have nogules that have been looked at through ultrasound and needle biopsy. No cancer detected. The ultrasound was done about 3 years ago. I have been having symptoms of dry cough, hourse voice, some trouble swallowing at times, and when I lay down there is a strong sense that there is something stuck in my throat approximately where my thyroid is located, hiccups and a visible swelling on the front of my neck where my thyroid is located, and at the base of my throat where my clavicle bones end. My question is, what do you think could be going on? Could this be growth of the nogules and a need to have them removed?
Brief Answer:
It could be growth. Repeat the scan and needle biopsy
Detailed Answer:
Hi XXXXXX,
Welcome to HCM. I had gone through your question and understand your concerns.
It could be an increase in size of thyroid.
Please let us know few things to give a better answer to your queries:
What was the size of the nodules in previous scan?
What is the latest thyroid function test reports?
For the thyroid nodules the follow up is to repeat an ultrasound after 6-12 months of 1st scan followed by an ultrasound scan every 1-2 yrs. If the size of the nodule is increasing more than 50% or original size or if any suspicious nodules are there, we have to repeat the needle biopsy again.
Since it is more than 3 years from your previous scan you have to repeat both the ultrasound scan of the neck and needle biopsy now. Your treating doctor will be able to decide on surgery after these tests. The indication of surgery are :
1. Size of nodule more than 4 cm
2. Needle biopsy suggestive or suspicious of cancer
3. Nodule extending behind your chest bones (retrosternal extension)
4. Significant pressure symptoms - like difficulty in speech, swallowing, neck pain etc
If you have any of these you should plan for surgical removal of nodule. If none are there we can wait for another year to do a repeat ultrasound scan.
Mean while test your thyroid function. If TSH is elevated it could be the reason for increase in size of thyroid swelling and you pressure symptoms in neck. This can be treated by increasing the dose of synthyroid.
Wishing you good health.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
It could be growth. Repeat the scan and needle biopsy
Detailed Answer:
Hi XXXXXX,
Welcome to HCM. I had gone through your question and understand your concerns.
It could be an increase in size of thyroid.
Please let us know few things to give a better answer to your queries:
What was the size of the nodules in previous scan?
What is the latest thyroid function test reports?
For the thyroid nodules the follow up is to repeat an ultrasound after 6-12 months of 1st scan followed by an ultrasound scan every 1-2 yrs. If the size of the nodule is increasing more than 50% or original size or if any suspicious nodules are there, we have to repeat the needle biopsy again.
Since it is more than 3 years from your previous scan you have to repeat both the ultrasound scan of the neck and needle biopsy now. Your treating doctor will be able to decide on surgery after these tests. The indication of surgery are :
1. Size of nodule more than 4 cm
2. Needle biopsy suggestive or suspicious of cancer
3. Nodule extending behind your chest bones (retrosternal extension)
4. Significant pressure symptoms - like difficulty in speech, swallowing, neck pain etc
If you have any of these you should plan for surgical removal of nodule. If none are there we can wait for another year to do a repeat ultrasound scan.
Mean while test your thyroid function. If TSH is elevated it could be the reason for increase in size of thyroid swelling and you pressure symptoms in neck. This can be treated by increasing the dose of synthyroid.
Wishing you good health.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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