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Lakeshore Ear Nose and Throat evaluates hundreds of patients with thyromegaly yearly. Evaluation usually consists of a thorough exam, blood tests, and a thyroid ultrasound. Other tests such a thyroid scans or fine needle aspirations might also be suggested. We work closely in conjunction with primary care physicians and endocrinologists to ensure our patients have the optimal care from multiple specialties.
The thyroid gland is located low in the neck just beneath the larynx or voice box. It is comprised of thousands of small cellular islands which produce thyroxine, a hormone which helps to regulate the body’s metabolism. A variety of circumstances can cause the thyroid to enlarge in size (a condition called thyromegaly.) Infection, chronic inflammation, goiter, and tumors are causes of thyromegaly. For more on the thyroid visit www.endocrineweb.com/thyroid.html.
Some causes of thyromegaly require no treatment. Others are managed with medicines. Occasionally, thyroid surgery is required for conditions including carcinoma, symptomatic goiter, and suspicious thyroid nodules. |
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A thyroid nodule is a lump discernible from the remaining thyroid gland. Ten to twenty percent of the population have at least one thyroid nodule; the overwhelming majority of people are asymptomatic.
Palpable nodules occur in approximately 4% of the population. While most of these nodules are benign, approximately 5-10% will harbor thyroid carcinoma.
Certain factors such as patient age, nodule size, and prior exposure to radiation can increase the chance that a given nodule harbors malignancy.
Any suspicious nodules should undergo fine needle aspiration. This procedure, often performed in the office, extracts cells from the nodule which are sent to pathology for analysis.
More on thyroid nodules:
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Thyroid goiter refers to an enlarged thyroid in the absence of inflammation, infection, or tumor. Most goiters are asymptomatic and can be followed and treated medically if necessary. Unchecked growth of the thyroid can sometimes lead to difficulty swallowing, voice changes, or breathing problems. If these symptoms develop and don’t respond to medical treatment, then thyroid surgery might be recommended.
Goiters typically contain many thyroid nodules. Certain nodules harbor a risk for thyroid carcinoma, thus all goiters should receive a thyroid ultrasound to check for large (dominant) nodules, or smaller nodules with suspicious features. Fine needle aspiration and/or thyroid surgery might be suggested if a goiter exhibits a nodule suspicious for carcinoma.
More on goiters:
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Cancer has ability to invade neighboring structures and spread to distant parts of the body. Well-differentiated thyroid carcinoma (the most common variety,) typically follows predicable patterns of spread with excellent chances for cure. Papillary and Follicular variants of well differentiated carcinoma have been described. Papillary Carcinoma can often be diagnosed after fine needle aspiration. Follicular carcinoma however is very difficult to diagnose preoperatively. For this reason thyroid surgery might
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be recommended after a fine needle which raises the possibility of a follicular neoplasm.
For more information on thyroid carcinoma visit the following websites:
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 Well differentiated thyroid carcinoma is treated surgically. Partial or total thyroidectomy is offered depending on the extent of disease. If surrounding lymph nodes are enlarged, then removal of the lymph nodes, called a neck dissection, is performed at the same time. Adjuvant therapy such as radioactive iodine and radiation are sometimes necessary following surgery.
Prior to surgery, it is important to discuss potential risks and benefits with your surgeon. The thyroid is intimately associated with nerves that control voice, as well as parathyroid glands responsible for regulating calcium. Voice change, difficulty swallowing, and low calcium can occur in a small percentage of patients postoperatively.
For more on thyroid surgery, visit http://www.endocrineweb.com/surthyroid.html
Calcium is critical for many bodily processes such as bone formation, nerve conduction, and muscle function. High calcium ( hypercalcemia) can cause constipation, abdominal pain, frequent urination, kidney stones, bone pain, and fatigue to name a few symptoms.
For more on calcium, visit www.healthatoz.com
There are many causes for high calcium, some of which are attributable to the parathyroid glands. The body has anywhere from 2-6 (but usually 4) parathyroid glands situated at various locations on both sides of the neck. They are usually, but not always, in close proximity to the thyroid gland (whence they derive their name.) Parathyroid glands regulate the amount of calcium available in the body through the production of calcitonin and parathyroid hormone. |
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Parathyroid surgery might be recommended if calcium is excessively high, a person is symptomatic, or if they’ve had complications such as bone loss, kidney disease, or frequent kidney stones.
For more on parathyroid surgery, visit http://www.endocrineweb.com/standardpara.html
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