Overview

• Abnormal growths within the thyroid gland
• F>M (4:1), incidence increases with age
• Majority are benign, but small proportion turn into thyroid cancer
• Benign → thyroid adenoma, thyroid cyst, multinodular goitre, hashimoto’s thyroiditis
• Malignant → thyroid carcinoma
  • Papillary Carcinoma ⇒ most common, 30-40 yrs old, metastasis to cervical lymph nodes (contrast to follicular). Very good prognosis.
  • Follicular Carcinoma ⇒ 2nd most common, 30-60 yrs old (typically presents later in life than papillary), more common in areas of low iodine and in women, metastasis to lung and bones.
  • Medullary Carcinoma ⇒ cancer of parafollicular cells, secrete calcitonin, part of MEN-2
• Nodules are usually non-functioning
• Causes of Thyroid Nodules
• Neck Lumps

Making Diagnosis

Clinical Features:

• Most are asymptomatic
• Single isolated nodule is more likely to be malignant
• Radiation to the head or neck is also red flag for thyroid cancer

Investigations:

All thyroid nodules should be investigated for malignancy