Thyroid Nodules
The thyroid gland is a butterfly-shaped gland just in front of the neck of the windpipe. Especially the thyroid and calcitonin hormones it secretes are essential for life. The growth of this gland outside of inflammation or tumor is called goiter. If the goiter is caused by a nodule that appears as a mass within the thyroid tissue, we call it nodular goiter. Nowadays, thyroid nodules are mostly detected during ultrasonography, neck tomography or PET scans performed for another reason, and more rarely, the complaint of presentation with an externally visible mass. The detection rate is also high in ultrasonography performed during pregnancy or during another scan due to a thyroid hormone level abnormality. Despite the rate of nodules varying between societies, the rate of cancer detection from these nodules varies between 4% and 6.5%. In short, thyroid cancer is detected in one out of every 20 patients with nodules and therefore tests are requested.
When thyroid nodules are detected or at the initial detection stage, the most common test we use is thyroid ultrasonography. It provides a preliminary diagnosis both from the radiologist’s point of view and from the point of view of the doctor who examines and performs your surgery, especially in nodules suspicious for tumors. If deemed necessary, a needle biopsy is performed after the ultrasonographic examination of your thyroid nodules.
Fine needle biopsy is the most common test we use to investigate tumors in thyroid nodules. If necessary, biopsies can be taken consecutively at certain monthly intervals, especially in ultrasonography findings that show suspicion of tumor. Thyroid needle biopsies determine the risk of thyroid cancer, and since this risk can range from 0 to 99%, there are pathology classifications. As the risk rate increases in these classifications, the frequency of surgery increases. In short, although needle biopsies do not make a definitive diagnosis, they guide us by determining the risk of cancer to a certain extent.
Thyroid nodules are not only at risk of cancer but are also likely to be toxic goiter due to excessive hormone secretion. For this reason, we check the hormone status of the nodules with thyroid scintigraphy in patients with high hormone levels and no risk.