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 as 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.
A thyroid nodule is a lump discernible from the remaining thyroid gland. Ten to twenty percent of the population has 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.
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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.
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Cancer has the ability to invade neighboring structures and spread to distant parts of the body. Well-differentiated thyroid carcinoma (the most common variety,) typically follows predictable patterns of spread with excellent chances for a cure. Papillary and Follicular variants of well-differentiated carcinoma have been described. Papillary Carcinoma can often be diagnosed after a fine needle aspiration. Follicular carcinoma, however, is very difficult to diagnose preoperatively. For this reason, thyroid surgery might be recommended after a fine needle which raises the possibility of a follicular neoplasm.
For more information on thyroid carcinoma visit the following websites: