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What is Thyroid Nodule Surgery?

For those who have thyroid nodules, thyroid nodule surgery is one treatment option available.

What Are the Types of Thyroid Nodules?

Benign Thyroid Nodules: An overgrowth of normal thyroid tissue can lead to a benign thyroid nodule. These nodules often times can grow to be large enough to cause problems with breathing and swallowing.

Your endocrinologist may recommend treating your benign thyroid nodule with suppressive medication like Synthroid or Levothyroxine. However, the American Thyroid Association does not typically recommend suppressive therapy due to its risk of side effects and the little chance it has to work. Thyroid hormone levels should be monitored frequently with suppressive treatment.

Malignant Thyroid Nodules: Malignant thyroid nodules are cancerous. Most thyroid nodules are non-cancerous, with only about 5 percent of these actually being confirmed as malignant. Most thyroid cancer patients can expect long-term remission or even full recovery.

There are different types of thyroid cancer and treatment will vary depending on the diagnosis. Typically, the thyroid gland will need to be removed through surgery. Surgical intervention is often followed by use of one or more radioiodine treatments, then thyroid hormone (Synthroid) suppressive therapy.

Suspicious for Malignancy: Thyroid nodules that appear to be suspicious for malignancy have a 50 to 75 percent risk of being cancerous. Due to the high risk factor, a total thyroidectomy is frequently performed on these patients.

Follicular Neoplasm: The the results of your biopsy may show a follicular neoplasm. If your nodules are considered low risk then your doctor may choose to schedule a follow up observation with you. However, approximately 15 to 20 percent of follicular neoplasms are cancerous, so it is recommended that these nodules be surgically removed.

If atypical cells are noted, patients may require a repeat biopsy, additional testing and/or an ultrasound. The results of the tests and the risk of thyroid cancer will determine the next treatment steps.

If there were not enough cells available from the biopsy to review, the test result is referred to as nondiagnostic. If this happens, your biopsy may be repeated with ultrasound guidance.

Sometimes nodules produce thyroid hormone but not in response to the body’s regulation of hormones. These nodules can lead to hyperthyroidism due to excessive production of thyroid hormone.

To reduce the risk of hyperthyroidism, these nodules are surgically removed.

Your doctor will decide how to treat these nodules based on your age, health, and other risk factors. In young adults, monitoring the nodules is recommended. However, surgical treatment is often recommended for those who are older because high thyroid hormone levels increase the risk of abnormal heart rhythm (atrial fibrillation) and bone loss (osteoporosis).

Fluid-filled benign nodules are referred to as cystic thyroid nodules. It is typically recommended that cystic nodules be monitored for changes. When the fluid is drained, these nodules cave in, thus decreasing in size. Cystic thyroid nodules may be surgically removed if they bleed or re-form more than once.

How Are Thyroid Nodules Treated?

Benign thyroid nodules can be managed by observation or surgery. Malignant thyroid nodules will most likely require surgical removal.

If biopsy and other thyroid tests still do not lead to a diagnosis, your doctor will discuss treatment options based on the test results and other factors.

Thyroid nodules that cause compressive symptoms should be surgically removed.

During thyroid gland surgery, the whole thyroid may be removed or simply the half of the thyroid where the nodule is present. Appropriate surgical treatment options will be discussed by your doctor.

When surgical removal of a thyroid nodule is not recommended, regular follow-up examinations are necessary.

How is Thyroid Surgery Usually Performed?

Like most other forms of surgery, thyroid surgery is done under general anesthesia in the sterile conditions of a hospital operating room.

Dr. Shatul Parikh at the Northwest Thyroid Center performs minimally invasive thyroid surgery. To learn more about our surgical techniques, click here.