The Thyroid Gland

What are thyroid nodules?

Thyroid nodules are growths in the thyroid gland, which is located in the front of the neck. The thyroid gland releases thyroid hormone, which regulates many of your body’s functions, including metabolism.

Thyroid nodules are very common in adults, and more than 70% of Americans over the age of 70 will have at least one. Most nodules are noncancerous (benign), but some can be cancerous. Thyroid nodules are less common in children and teens, but, if a child or a teen has a nodule, it is more likely to be malignant (cancerous).

There are several types of thyroid nodules: 
  • Colloid nodules are benign buildups of thyroid cells.
  • Follicular adenomas are also benign.
  • Thyroid cysts are balloon-like growths inside of your thyroid gland that are filled with fluid. They are almost never cancerous.
  • Thyroid cancers can appear similar to any of the other types of thyroid nodules. An ultrasound and, sometimes, a biopsy are important to determine if a nodule is malignant.
     
Some nodules may affect the hormones produced by the thyroid gland, causing symptoms of hypothyroidism (underactive thyroid gland) or hyperthyroidism (overactive gland).


Thyroid Nodule Symptoms

Many thyroid nodules do not cause symptoms until they are large enough to affect the surrounding tissues and organs or to be visible on the neck. Depending on the type and cause of the nodule, symptoms may include:

  • Difficulty swallowing
  • Hoarseness or other voice changes
  • Pain in the neck
  • A swelling in the neck that you can see or feel (goiter)
  • Sudden, rapid weight loss
  • Fast or irregular pulse
  • Nervousness or anxiety
  • Cold intolerance
  • Fatigue
  • Dry skin
  • Weight gain
  • Facial swelling (edema)

Thyroid Nodule Diagnosis

  • Physical exam/palpation
  • CT scan
  • Ultrasound of the neck
  • Blood tests to measure the level of thyroid hormones in the blood
  • Biopsy of the nodule, which involves taking a small sample of the nodule and examining the cells under a microscope. This is the best way to determine whether a nodule is benign or cancerous.

When to See a Doctor for a Thyroid Nodule

If you or your child has any of the symptoms listed above, consult your health care provider.  

Thyroid Nodules: Treatment

Treatment will depend on the type and cause of the nodule. Sometimes observation (watchful waiting and regular follow-up) is all that is needed. Medication and surgery may also be necessary. Radio frequency ablation (RFA) is a nonsurgical procedure that can also reduce the size of a thyroid nodule. 

Radiofrequency Ablation (RFA) for Benign Thyroid Nodules

Head and neck endocrine surgeon Jonathon Russell describes how radiofrequency ablation (RFA) is used, who is an appropriate candidate and what is involved in this new treatment approach.

The Thyroid and Parathyroid Center at Johns Hopkins' Department of Otolaryngology and Head and Neck Surgery

Patients with thyroid or parathyroid conditions, including tumors, nodules and hyperparathyroidism, can rely on the expertise of our team. Our specialists offer expert imaging and diagnosis, along with medical and surgical management and personalized, compassionate care. We were among the first hospitals in the United States to offer scarless vestibular robotic thyroid surgery, and our teams were among the first to offer radiofrequency ablation (RFA). Our position as world leaders in the care of thyroid nodules and thyroid cancer ensures that you and your family will receive the most appropriate patient-centered care available. 

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