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When Should Enlarged Heterogeneous Thyroid Gland Be Removed?
Question: I am to have an FNA done of an enlarged heterogeneous thyroid gland, with multiple bilateral nodules, with a dominant solid nodule within the left lower thyroid lobe measuring 5.7 x 4.2 x 2.8 cm. Will this just probably need to be removed anyway because of the size? I have no symptoms, and blood work is normal. Also, how horrible is the FNA? There are lots of nasty stories out there.
Brief Answer:
Thyroid nodule
Detailed Answer:
A decade ago, nodules this size were typically removed but newer wisdom has shown that size alone is not the deciding factor. There are several things to consider :
1 Do you have family history of thyroid cancer?
2 Have you ever been exposed to upper body radiation such as radiation treatment for upper body cancers or acne?
3 What are the ultrasound features of the nodule other than size ( is it hypo echoic, with regular margins, and is it vascular and does it have any calcifications )
4 What is your TSH blood test result?
5 You dont seem to have any compressive symptoms from it such as
difficulty speaking
difficulty breathing
hoarseness
change in voice
difficulty swallowing
FNA is not excruciatingly painful but people's pain thresholds vary. Some patients feel only pressure while others may experience a more painful sensation
Thyroid nodule
Detailed Answer:
A decade ago, nodules this size were typically removed but newer wisdom has shown that size alone is not the deciding factor. There are several things to consider :
1 Do you have family history of thyroid cancer?
2 Have you ever been exposed to upper body radiation such as radiation treatment for upper body cancers or acne?
3 What are the ultrasound features of the nodule other than size ( is it hypo echoic, with regular margins, and is it vascular and does it have any calcifications )
4 What is your TSH blood test result?
5 You dont seem to have any compressive symptoms from it such as
difficulty speaking
difficulty breathing
hoarseness
change in voice
difficulty swallowing
FNA is not excruciatingly painful but people's pain thresholds vary. Some patients feel only pressure while others may experience a more painful sensation
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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