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Thyroid nodule

Thyroid tumor - nodule; Thyroid adenoma - nodule; Thyroid carcinoma - nodule; Thyroid cancer - nodule; Thyroid incidentaloma; Hot nodule; Cold nodule; Thyrotoxicosis - nodule; Hyperthyroidism - nodule

A thyroid nodule is a growth (lump) in the thyroid gland. The thyroid gland is located at the front of the neck, just above where your collarbones meet in the middle.

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Thyroid gland biopsy

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Causes

Thyroid nodules are caused by an overgrowth of cells in the thyroid gland. These growths can be:

Thyroid nodules are very common. They occur more often in women than in men. A person's chance of getting a thyroid nodule increases with age.

Only a few thyroid nodules are due to thyroid cancer. A thyroid nodule is more likely to be cancer if you:

Causes of thyroid nodules are not always found, but can include:

Symptoms

Most thyroid nodules do not cause symptoms.

Large nodules can press against other structures in the neck. This can cause symptoms such as:

Nodules that produce thyroid hormones will likely cause symptoms of overactive thyroid gland, including:

Older people with a nodule that produces too much thyroid hormone may have only vague symptoms, including:

Thyroid nodules are sometimes found in people who have Hashimoto disease. This may cause symptoms of an underactive thyroid gland, such as: 

Very often, nodules produce no symptoms. Health care providers often find thyroid nodules during a routine physical exam or imaging tests that are done for another reason. A few people have thyroid nodules that are big enough that they notice the nodule on their own and ask a provider to examine their neck.

Exams and Tests

If a provider finds a nodule or you have symptoms of a nodule, the following tests may be done:

Treatment

Your provider may recommend surgery to remove all or part of your thyroid gland if the nodule is:

People with nodules that are making too much thyroid hormone may be treated with radioiodine therapy. This reduces the size and activity of the nodule. Pregnant women or women who are still breastfeeding are not given this treatment.

Both surgery to remove thyroid gland tissue and radioactive iodine treatment can cause lifelong hypothyroidism (underactive thyroid). This condition needs to be treated with thyroid hormone replacement (a daily medicine).

For noncancerous nodules that do not cause symptoms and are not growing, the best treatment may be:

Another possible treatment is an ethanol (alcohol) injection into the nodule to shrink it.

Outlook (Prognosis)

Noncancerous thyroid nodules are not life-threatening. Many do not require treatment. Follow-up exams are enough.

The outlook for thyroid cancer depends on the type of cancer. For most common kinds of thyroid cancer, the outlook is very good after treatment.

When to Contact a Medical Professional

Contact your provider if you feel or see a lump in your neck, or if you have any symptoms of a thyroid nodule.

If you have been exposed to radiation in the face or neck area, contact your provider. A neck ultrasound can be done to look for thyroid nodules.

Related Information

Thyroid cancer - medullary carcinoma
Multiple endocrine neoplasia (MEN) II
Thyroid cancer
Chronic thyroiditis (Hashimoto disease)
Laryngeal nerve damage
Thyroid gland removal
Thyroid gland removal - discharge

References

Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. PMID: 26462967 pubmed.ncbi.nlm.nih.gov/26462967/.

Filetti S, Tuttle M, Leboulleux S, Alexander EK. Nontoxic diffuse goiter, nodular thyroid disorders, and thyroid malignancies. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 14.

Jonklaas J, Cooper DS. Thyroid. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 213.

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Review Date: 5/13/2020  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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