A 37-year-old Mr. Liu has good living habits. He only feels that his throat is not smooth occasionally, and he can’t sing high notes when singing with friends. One day, when I was scratching, I felt a protrusion of about 2 cm on the right neck. I performed an ultrasound examination of the neck. It was found that there was an uneven mass of about 3 cm in the right thyroid with tiny calcifications. After further puncture examination, it was confirmed that it was a malignant tumor. Therefore, right thyroidectomy and isthmus resection and right central lymph node dissection were performed.

After the operation, he received radioactive iodine 131 therapy and is currently recovering well.

According to clinical statistics, the incidence of thyroid nodules is between 20-60%. Some people get a physical examination report and find a suspected thyroid nodule. They need to go to the hospital for further examination. , thyroid cyst, thyroid tumor and other names, quite tangled, is it the same disease, or are there differences?

Thyroid nodules, which can be large or small, should be identified as soon as possible

The thyroid gland is an endocrine organ of the human body, which secretes thyroxine and is responsible for many functions such as metabolism, growth and development of the whole body. If a thyroid nodule is found that cannot be ignored, it is necessary to do a differential examination to find out whether it is benign or malignant.

Thyroid swelling may be caused by thyroid inflammation, or it may be a nodule caused by cell proliferation. Most of these abnormal nodules are benign masses, and a few are malignant tumors. If only one nodule appears, it is called a single nodule If there is more than one nodule, it is multiple nodules, and the causes are related to family inheritance, autoimmune disease, insufficient iodine intake, drinking water or food containing goiter-causing substances, and previous radiation exposure to the head and neck.

There are three main types of abnormal thyroid nodules

Abnormalities found on thyroid ultrasound can be broadly classified as thyroid cysts, thyroid nodules, or goiter.

Thyroid cyst

Refers to the discovery of cysts in the thyroid gland, generally containing liquid, the contents are mainly bleeding, viscous colloid or cell tissue fluid and other liquids, which may be caused by blood vessel bleeding in the nodule or thyroid cells secreting colloid. If the cyst continues to grow larger, affects the appearance, or causes pain or pressure from the hemorrhagic cyst, consider using a fine needle to extract the fluid to make the cyst smaller and reduce the pressure, and then follow-up observation. of cysts, surgical excision or other treatments may be considered.

Thyroid nodules

It refers to the solid tumor of the thyroid gland, which can be divided into benign nodules and malignant nodules. Most of the nodules are benign tissues. If a benign nodule has no malignant features and no compression symptoms, follow-up observation is generally the main focus. Although thyroid nodules are mostly benign, they cannot be ignored, but should pay attention to the changes of the nodules. According to clinical experience, when the nodule grows rapidly, or the size of the nodule exceeds 4 cm, or the nodule affects the appearance, or has compression symptoms, or even has hoarseness and difficulty in breathing and swallowing, surgical resection should be considered.

goiter

Commonly known as big neck disease, it refers to the diffuse and uniform enlargement of the entire thyroid gland.

Benign thyroid nodules still require regular ultrasound examinations

A nodule is an abnormally proliferating mass in tissue, which needs to be diagnosed by blood drawing, ultrasound, cell puncture, etc. If it is shown as a benign tissue, it is determined that it is not a malignant tumor, does not affect thyroid function, or the mass is not large enough It will compress the esophagus or trachea, and may never need treatment; however, there is still a very small possibility of undiscovered malignant cells, and it does not rule out that the nodule may grow in the future. , hardening, you need active treatment.

If you feel a thyroid mass, such as a benign thyroid nodule, must surgery be performed?

This is not necessarily! Which conditions require surgery? There are the following three:

1. Suspected malignant tumor

When a doctor makes a diagnosis, the thyroid gland is hard or irregular on palpation. The patient may have a hoarse voice, vocal cord paralysis, or enlarged cervical lymph nodes. The nodule is calcified by ultrasound or CT, or the pathology shows that When the risk of malignancy is high, consider surgical resolution to prevent delayed treatment.

2. Affect the appearance or have uncomfortable symptoms

In some patients, the tumor will compress the trachea and esophagus, which may affect the patient’s breathing and swallowing, resulting in a strong sense of discomfort. At this time, it can be relieved by surgery to prevent the tumor from becoming larger in the future, increasing the difficulty and complications of surgery. Case.

3. When symptoms of hyperthyroidism appear, but the drug treatment is still not well controlled.

Some people with asymptomatic benign thyroid nodules are worried about the nodules and still want to remove them. Generally, doctors recommend unilateral surgical resection instead of bilateral resection. Retaining the thyroid nodule on one side can maintain the original thyroid gland. Function.

On the contrary, some patients are worried that the voice will be affected after thyroidectomy, in fact, the incidence of recurrent laryngeal nerve damage caused by thyroidectomy is only about 1-2%. The recurrent laryngeal nerve mainly controls the activity of the vocal cords of the larynx. When damaged, it can lead to hoarseness and choking when swallowing. Fortunately, most hoarseness can be gradually improved, and it can also be improved by sound therapy.

Thyroid cancer treatment is better

Many patients know that they have thyroid cancer, and they will be afraid and worry about their health. In fact, thyroid cancer is a relatively low-malignancy tumor, which can be cured and is recognized as one of the cancers with a better prognosis. The survival time of cancer statistics is generally based on 5 years, but thyroid cancer is based on 10 years, and the survival rate exceeds 90%. Early detection, early diagnosis, and early treatment, patients can generally return to normal life.

Thyroid cancers are classified into papillary, follicular, medullary, and anaplastic cancers according to cell morphology.

Among them, mastoid cancer has the highest proportion, accounting for about 8.5-90%; follicular cancer accounts for about 10%. Since these two types of cancer have relatively good cell differentiation, regular review and active treatment will not have much impact on the normal life of patients. ; About 1-2% of medullary carcinomas, of which a quarter of the patients are related to family genetic mutations, the degree of malignancy is higher than that of other tumors, and multiple tumors are also prone to occur.

The most worrying is undifferentiated carcinoma, which accounts for about 1%. Once this kind of tumor appears, it may grow rapidly in a short period of time, about 1-3 months. Generally, the texture is hard and will invade quickly Around, metastases are formed, so the mortality rate of this type of tumor is very high.

Thyroid cancer is mostly in women, but men should also pay attention

Modern statistics show that the prevalence of thyroid cancer is higher in women than in men.

So why do women with thyroid cancer make up the majority?

According to statistical research results, among the common thyroid diseases, hyperthyroidism or hypothyroidism, goiter and thyroid nodules, the incidence of women itself is more than that of men, and the older the age, the greater the proportion. It is for this reason that the number of women suffering from thyroid cancer is also higher, about four times that of men.

However, it does not mean that men will not get sick. If a man finds a lump on his neck or his voice is hoarse, he also needs to pay attention. To rule out the possibility of disease, go to the corresponding department for examination as soon as possible. For example, you can consider going to the ear, nose and throat. Department or surgery, etc., modern inspection equipment can find problems at the first time. Even if you don’t have thyroid problems, worry about the effects of other medical conditions.

The real cause of thyroid nodules and thyroid cancer is not yet very clear, but statistical research believes that family inheritance is one of them. About 10% of people have family genetic problems , so if a family member ever has thyroid nodules or suffers from thyroid disease Cancer, such people should also pay more attention and need to have a physical examination every year.

In addition, among the known reasons, radiation can also affect and damage the thyroid gland. For example, radiologists in hospitals may be affected by radiation. Similarly, patients should not receive many radiation examinations each year. Exceeding a certain radiation dose can also cause cancer. possible, and food with radiation should also be avoided.