Widespread – 50% population have a thyroid nodule
The majority are benign – 90-95%
No correlation with thyroid hormone levels
- Swelling in front of the neck(most common)
- Swelling inside of the neck
- Change in voice
- Difficulty in breathing/eating
Tests To Do
- If suspicious – USG guided FNAC
- CT/MRI scan if necessary
- PETCT – not much role
FNAC - no cancer what to do
FNAC negative -> No other risk factors -> Regular Follow-ups
FNAC – Cancer, what to do?
- Cancer – Differentiated thyroid cancer – very good prognosis
- Rare types medullary ca thyroid and anaplastic ca – poor prognosis
- The younger age group has the best prognosis
- 10-year survival – 90- 95%
- Surgery is the main treatment
- Radioiodine treatment in selected cases after surgery
Surgery For Thyroid Cancer
- Small Tumors – total removal of the thyroid
- Larger Tumors – total removal of thyroid with the removal of neck nodes
Thyroid Surgery and voice change
- Why the worry?
- Recurrent Laryngeal nerve courses underneath the thyroid
- Direct/Indirect injury can cause temporary/permanent damage.
- So should one avoid surgery?
- Risk of permanent nerve injury in experienced hands < 3%.
- No other alternatives to surgery.
- What other problems to expect?
- Hypocalcemia – Low calcium levels
- Bleeding, infection
- Superior laryngeal nerve injury
- What happens after surgery
- Based on the surgery report decision will be taken on the need for radioiodine therapy
- They were usually given 4-6 weeks after surgery.
- The patient is to be on an iodine-free diet and no thyroxine.
- Regular Follow-ups.
- Serum Thyroglobulin and scan
- Recurrences can be treated.