THYROID LUMPS AND GOITRE
There are essentially four possible situations that can underlie an enlargement of the thyroid gland:
- A single lump or nodule within the thyroid gland
- Lots of nodules in the thyroid gland (multinodular goitre)
- A generalised enlargement of the whole thyroid gland (Goitre)
- Lots of nodules but one which is particularly large (a dominant nodule)
Lumps or nodules within the thyroid gland are quite common,especially in females. Most of these are benign. However, in the situation of a single lump or nodule within the thyroid gland, 5% will be malignant or cancerous. Benign lumps, if proven to be as such (see below) often do not need any treatment. The focus of investigation is to diagnose, where possible, a lump as either benign or malignant. This applies to a single lump or a dominant lump in a multinodular goitre.
Goitres can occur in puberty or pregnancy as temporary phenomena. Goitres can also occur as a result of autoimmune disease, whereby the body makes antibodies against the thyroid gland causing it to be inflamed.This can be associated with under- or over-function of the gland, but not necessarily so.
A goitre can also be caused by the formation of multiple nodules within the thyroid gland (multinodular colloid goitre).
The clinical issues with thyroid lumps and goitres are:
- To make sure the underlying cause is not cancer
- To ascertain whether the lump is causing problems through size, e.g. compression of other structures (trachea, oesophagus, throat).
- To ensure there is no abnormal function (over or under) of the thyroid gland