Thyroid surgery
The gland is removed, whole or one lobe, according to the diagnosis. The voice and the parathyroids are the technical priority.
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Thyroid nodule and goitre in Tijuana: when surgery is indicated
A lump in the neck. The great majority are benign and are monitored; ultrasound and fine-needle biopsy are what separate the ones that need surgery.
What this condition actually is
A thyroid nodule is a localised growth within the thyroid gland. They are very common, especially in women and with age, and today many are discovered incidentally on imaging ordered for something else. The point worth being clear about from the start is that the great majority are benign.
Investigation follows a well-established sequence. First, thyroid function tests, which say whether the gland is working too much, too little or normally. Second, neck ultrasound, which describes the size, composition and features of the nodule and assigns it a level of suspicion. Third, and only if that level justifies it, ultrasound-guided fine-needle aspiration biopsy.
That biopsy is the tool that decides. With its result it is known whether the nodule is monitored with periodic ultrasound or whether it has a surgical indication. Operating on every nodule would be as wrong as investigating none: hence the sequence, and hence the value of respecting it.
Symptoms and warning signs of thyroid nodule
- A palpable or visible lump in the front of the neck
- A sensation of pressure in the neck or on swallowing
- Voice changes or persistent hoarseness without a clear cause
- Symptoms of hormone excess: palpitations, weight loss, tremor, insomnia
- Symptoms of deficiency: fatigue, weight gain, cold intolerance, dry skin
- RAPID GROWTH, A HARD FIXED NODULE OR NECK NODES: investigate without delay
Procedures
Surgical treatment of thyroid nodule
The procedures that may be indicated for this condition. Which one applies to you — if any does — is decided on your imaging and your examination.
Surgical biopsies
Without a histological diagnosis there is no correct treatment. The biopsy answers the question: what exactly is this.
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Tumor resection
A tumour is not removed to find out what it was. It is investigated, the margin is planned, and then it is operated on.
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FAQ
Questions patients ask about thyroid nodule
Red flags: do not wait for an appointment
SEVERE ABDOMINAL PAIN THAT DOES NOT LET UP, fever with pain in the right side of the abdomen, VOMITING THAT PREVENTS KEEPING FLUIDS DOWN, distension with no gas or bowel movements, A HERNIA THAT HAS TURNED HARD AND CANNOT BE PUSHED BACK IN, or vomiting or stool WITH BLOOD. Go to an emergency department immediately and call (662) 282-1787.
Most likely not: the great majority of thyroid nodules are benign. But that is not decided by probability, it is decided by investigation. Ultrasound assigns a level of suspicion and, where that justifies it, fine-needle biopsy gives the answer.
It is a brief procedure, with a very thin needle and ultrasound guidance. The discomfort is comparable to a blood draw and it requires neither general anaesthesia nor fasting. It is done in clinic and the patient walks out.
Generally it is not done that way. Removal is by lobe — hemithyroidectomy — or of the whole gland, because removing only the nodule compromises the quality of the histopathological study and leaves tissue with the same problem. The extent is defined by the diagnosis.
No. Many goitres are monitored or treated medically. Surgery follows compressive symptoms — difficulty swallowing or breathing — extension into the chest, suspicion of malignancy, or associated hyperthyroidism that is not controlled.
Surgical consultation
Bring your studies and settle the question
One consultation with your ultrasound or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.