Thyroid Nodules & Treatment During Parathyroid Surgery
Introduction
Thyroid nodules refer to lumps found in the thyroid gland. They are most often benign, but some
are cancerous, and some can get large enough to press on surrounding tissues & cause symptoms; good news is that it can be taken care of at the same time as having surgery for hyperparathyroidism.
What Is a Thyroid Nodule?
- A thyroid nodule is a lump (aka: mass, lesion) in the thyroid gland.
- Most thyroid nodules are solid or cystic (filled with fluid), and they are found on any portion of the thyroid gland.
- They can be very small or large enough to put pressure on the surrounding structures (breathing tube, esophagus etc…).
What Are the Symptoms of a Thyroid Nodule?
- The great majority of thyroid nodules are small and cause no symptoms. They are usually found incidentally when a person is having a scan done for other reasons: neck pain etc…
- Common symptoms of thyroid nodules include neck discomfort, pressure on the trachea breathing tube), an urge to swallow, or difficulty wallowing.
- In rare cases, a thyroid nodule can produce extra thyroid hormone that can lead increased metabolism and high level of extra functioning of our organs.
- Thyroid nodules are common, much more common then hyperparathyroidism.
Thyroid Nodules Testing
- To evaluate a thyroid nodule, thyroid blood tests and thyroid ultrasound are the most important first steps. The blood test can tell us if the nodule is producing too much hormone or not. The ultrasound can tell if the nodule appears benign or suspicious.
- If on the ultrasound the nodule has suspicious features, the a fine needle biopsy (FNA) can be done that can tell us more crucial information.
Thyroid Nodules Surgery Options
- Based on the evaluation of the thyroid nodule, if the nodule is benign then ONLY THE NODULE WILL BE REMOVED and not the remainder of the thyroid gland. This allows the thyroid gland to continue to produce the same amount of thyroid hormones, and very much minimize the chance of taking thyroid hormone medications after surgery.
- If the nodule is not benign then based on the size, location and extent of the aggressive nodule, half of the thyroid or the entire thyroid will be removed.
Thyroid Nodule Management During Parathyroid Surgery
When you are being evaluated for hyperparathyroidism, immediately before surgery all patients seen at the CENTER will have an ultrasound done to look at the exact neck anatomy and assess the parathyroids and thyroid gland. If there are any thyroid nodules, and the thyroid nodules are benign or appear benign, they may be removed at the same time if it is accessible and doesn’t pose additional risks.
If the nodule appears highly suspicious and has not undergone a needle biopsy yet, it will be removed during parathyroid surgery and sent to the pathologist to be analyzed immediately and during the surgery. If it is a cancerous thyroid nodule then the appropriate thyroid surgery is done at the same time. All of this will be discussed and planned with you prior to the surgery.
If nodule is biopsy proven cancer then the plan will be for either a hemithyroidectomy (removing half of the thyroid gland) or total thyroidectomy (removing the entire thyroid gland), which will also be planned with you prior to the surgery.
Conclusion
Dr. Babak Larian of the CENTER for Advanced Parathyroid Surgery offers minimally invasive parathyroidectomy surgery and will address the thyroid nodules when appropriate for patients who have HPT & thyroid nodules at the same time. To learn more or to schedule a consultation with Dr. Larian, please contact us online or call us today at 310.461.0300.