"The management of thyroid pathology is complex. Different thyroid specialists at the Clinic work together to apply the exact treatment each patient needs".
DR. JUAN CARLOS GALOFRÉ FERRATER
SPECIALIST. THYROID DISEASE AREA
What is a thyroid nodule?
A thyroid nodule is a focal growth that takes place in the thyroid gland. They can be single or, more often, multiple, forming a multinodular goiter.
Thyroid nodules can:
- Have a liquid content, in which case they are called cysts.
- Be formed by predominantly cellular tissue, in which case they are said to have a solid structure.
- Show a mixed structure: solid and cystic.
Specialists from the Thyroid Pathology Area of the Clínica Universidad de Navarra have set up a Fast Track protocol for the diagnosis and complete treatment of thyroid nodules in 24 hours.
The patient arrives at 9:00 a.m. at the Endocrinology Clinic, where he or she will be examined. At 10 a.m., the ultrasound scan with a thyroid study is performed by means of a puncture with a very fine needle. The material obtained is quickly processed by the Pathological Anatomy Laboratory and around 1 p.m. we have the diagnosis of whether or not that nodule is malignant.
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What are the symptoms of a thyroid nodule?
In the vast majority of cases, thyroid nodules do not produce any symptoms, except for possible evidence of a lump located in the anterior region of the neck.
When their growth is important, they can produce compressive effects on neighboring structures, such as the trachea, esophagus or recurrent nerves, producing breathing difficulty, swallowing alterations or aphonia.
If they are hyperfunctioning nodules, they can lead to hyperthyroidism.
Rapid growth, hard consistency and the appearance of nodes are signs of suspected malignancy. In these cases, a correct diagnosis, adequate treatment and a follow-up plan are of vital importance.
Cómo saber si un nódulo en el cuello es benigno
The most common symptoms are:
- Lump in the anterior region of the neck.
- Breathing difficulty.
- Alterations in swallowing.
Do you have any of these symptoms?
You may have a thyroid nodule
What are the causes of the thyroid nodule?
In most cases, the cause of the appearance of thyroid nodules is not well known although in many cases there is an important genetic component.
Among the most frequent causes are:
- Focal hemorrhage is frequent, resulting in nodular formation.
- Excessive production of colloidal material.
- Autoimmune thyroiditis can acquire nodular morphology and form a thyroid nodule.
Only 10% of thyroid nodules are due to thyroid cancer.
What is the prognosis of the thyroid nodule?
Most thyroid nodules tend to maintain a stable behavior but it is necessary to perform periodic reviews that allow early detection of alterations in size, general characteristics or function that force a change in the treatment.
The prognosis of malignant nodules after surgery and treatment with radioactive iodine depends on the type of carcinoma, size of the nodule, extent of resection and metastatic extension.
How is the thyroid nodule diagnosed?
The initial diagnosis of one or more thyroid nodules is usually made by inspection and palpation by the doctor in a medical examination for any other reason.
Once the nodule has been detected in the thyroid, the diagnosis is made by means of an ultrasound scan with cytological study by fine needle aspiration, which is very sensitive for the diagnosis of the malignancy of the thyroid nodule.
The material extracted in this puncture is sent to the Pathological Anatomy Service where it is analyzed immediately. Thus, in less than 4 hours from their arrival at the Clinic, we can inform the patient of the result of the study and know if the nodule they present is benign or not.
The team of specialists in the Thyroid Pathology Area will indicate the most appropriate treatment for the patient in his or her specific case, and in less than 24 hours the treatment can be carried out.
Fast-track diagnosis in 4 hours of a thyroid problem at the Clínica Universidad de Navarra. (only in spanish)
How is the thyroid nodule treated?
We have an Area of Thyroid Pathology specialized in thyroid problems
If the result of the cytology is benign and the nodule is less than 4 cm, only a periodic review will be sufficient, in which clinical and ultrasound controls will be carried out.
If the nodule is benign but is larger than 4 cm, surgical treatment is usually recommended (a hemitiroidectomy is usually enough) or, if surgery is to be avoided and the nodule has certain characteristics, the nodule can be ablated by radiofrequency. This therapy reduces the size of the nodule by 40-90% a year after the treatment is performed.
If the result of the cytology is compatible with the malignancy, admission can be scheduled for that same afternoon or the following day to proceed with the surgical treatment.
In cases of benign hyperfunctioning nodules, surgical treatment or administration of radioactive iodine is scheduled.
Thyroid surgery is usually performed transaxillary, endoscopically or robotically, to avoid scarring of the neck.
Where do we treat it?
IN NAVARRA AND MADRID
The Thyroid Pathology Area
of the Clínica Universidad de Navarra
The Thyroid Pathology Area is made up of a multidisciplinary team of specialists who work together to offer patients with thyroid problems an accurate diagnosis.
After the diagnosis, the patient is indicated the most appropriate treatment for his or her case and a continuous follow-up is carried out to achieve the desired objectives.
The Clinic is a pioneer in the implementation of medical techniques in Spain and worldwide, and is an international reference in highly specialized procedures.
Why at the Clinica?
- Prestigious professionals who are a national reference.
- In 24-48 hours we make the diagnosis and we can start the most appropriate treatment for each patient.