Thyroid nodules should be treated?

3 years ago, when the doctor told her that trabecular examination of thyroid long three small Liuzi, she checked a lot of information on the Internet, went to many hospitals in consultation with the doctor, with some saying that surgery should be as soon as possible, or likely to become cancer Liuzi Some say it does not matter, you can continue to observe. This year's examination found that there are still three small Liu Zi, there is a still growing up into a soybean size. Is to continue to observe or change?

    In fact, thyroid nodules are common, by a doctor can feel touch, about 3% of our population to 7%, while the ultrasound if it is done, then about 20% of normal can be found in nodular thyroid gland. In which more women than men (4:1), middle-aged than in young people more common. Thyroid nodules Despite such a high incidence of the vast majority are benign, malignant only 5%. So how can we not miss this minority of "bad elements" but not so "friendly fire" that could be with people "peaceful coexistence" benign it?


    Distinction between benign and malignant thyroid nodules can be from the next several aspects.


    1. Age and gender: while women in the incidence of thyroid nodules than men, but men, the incidence of thyroid cancer than women in the high 2 ~ 3 times, childhood occurs 50% of thyroid nodules are malignant, 20 years of age 60 years old is a high-risk population of thyroid cancer.


    2. Medical history and family history: If you have done previously in head and neck radiation therapy and that the possibility of thyroid malignant lesions relatively large; there is that if the next of kin have medullary thyroid carcinoma or multiple endocrine tumors, thyroid cancer occurs the opportunity is higher.


    3. Tumor size: the current that is less than 1 centimeter tumor unless there are other factors highly suspected cancer, otherwise you can continue to observe.


    4. Nodule growth rate: fast-growing nodules tips for cancer, but in some cases is a sudden forceful coughing or suddenly discovered thyroid nodules clearly grown up, this mostly internal bleeding caused by adenoma, while the is not a cancer.


    5. Nodular texture: A texture is relatively soft, smooth, you can hand pushing the dynamic of the nodules are mostly benign. A hard, fixed, painless nodules, when the chance of a vicious (but there are exceptions).


    6. The number of thyroid nodules: a single cancerous nodule opportunity more than multi-nodular goiter; If you have multiple nodules, but not big, you can continue to observe.


    7. Thyroid nodules cause significant pressure symptoms (difficulty breathing or swallowing), or a hoarse voice who should be surgery.


    8. B-ultrasonic examination whether calcification: calcification is often one of the manifestations of many malignant tumors, but for the thyroid gland, be specific treatment. If it is sand-like calcification (less than 1 mm) is the possibility of cancer, large, but if it is not necessarily the chunks of calcification.


    9. Cervical lymph node metastasis: The side of thyroid nodules, while the ipsilateral neck lymph nodes, and hard who should be considered is the cancer and the occurrence of lymph node metastasis.


    10. There are also aimed at identifying the special examination of thyroid, such as radionuclide scanning, thyroid peroxidase (TPO), calcitonin, CD26, CD97 and other serum markers of differentiating benign and malignant masses there is a certain reference value.



    Contrast above 10, if the basic rule out cancer, you can observe the medication. Specific method is: multiple nodules or a single nodule of less than 1cm to oral L-50 ~ 100ug thyroxine tablets once a day (take half an hour before breakfast), 3 to 6 months after the review of B-, understanding the changes in mass. If the lump is getting smaller, you can continue to take six months after the slowly decrement. However, this method more than 2 centimeters of the tumor is usually less effective, and easy to relapse after drug withdrawal. For the medication invalid, tumor growth was sustained, then the proposed surgery. In view of the degree of malignancy of thyroid papillary carcinoma is relatively low, 3-month observation period would not affect the long-term effect.


    Review aspects, B super-discovery intangible thyroid nodules, it may not take medicine on a regular basis B-follow-up review, if necessary, feasible, CT, MRI examination. Solid or cystic-solid nodules, review once every six months. Single cystic nodule, reviewed once a year and pay attention to signs of hyperthyroidism and blood T3, T4, TSH levels. Follow-up review period, significantly increased nodule or nodules Chaoguo 1.5 cm who may wish to consider surgery. Conditions can also be down in the B ultrasound-guided fine-needle aspiration biopsy of suspected malignant or associated with hyperthyroidism were required surgery.


    Like trabecular only three small nodules, there is no sign of suspected cancer, so benign a great possibility, they do not take medicine, let alone surgery. The most appropriate approach is to regularly (six months or so) review of follow-up with high-resolution ultrasound, and then listen to the views of a doctor. Needs to be emphasized is that in the period of observation, whether drugs, thyroid nodules have malignant potential and therefore can not be taken lightly. Excessive tension and the "indifferent" are not desirable.

    Currently consists of General Surgery, Xiangya Hospital, Central South University, including many large hospitals feasible to conduct of endoscopic thyroidectomy, the operation is high security and can be completely dispel concerns about patient's neck scar, but is only suitable for benign disease or early stage cancer patients. Therefore, for judging the nature of mass is somewhat ambiguous and / or ideological concerns heavier patients, early for the implementation of endoscopic thyroidectomy may well be a good choice.