Thyroid Nodules

What it is

Thyroid nodules are very common, especially in women, and most are discovered incidentally on imaging tests of the neck. The vast majority are benign and cause no symptoms, but every nodule deserves careful evaluation to decide whether it needs only observation, a biopsy or treatment. The endocrinologist analyzes the nodule's features on ultrasound, checks whether hormone production is normal, and identifies risk factors such as family history and previous radiation exposure. This makes it possible to classify the risk and propose the right follow-up interval, avoiding both neglect and unnecessary procedures. The patient is clearly informed at every step.

Most common symptoms

• In most cases, no symptoms at all
• A lump or visible swelling in the neck
• A feeling of pressure or discomfort when swallowing
• Persistent hoarseness with no apparent cause
• Symptoms of excess hormone, such as palpitations

Causes and risk factors

• Benign growth of thyroid cells (adenomas and cysts)
• Iodine deficiency in the diet
• Hashimoto's thyroiditis and other inflammation of the gland
• Family history of nodules or thyroid cancer
• Previous radiation exposure to the neck area

How it is diagnosed

The evaluation starts with a physical exam of the neck and a clinical history, including family cases and radiation exposure. Ultrasound is the central test: it describes each nodule's size, composition, margins, presence of calcifications and blood flow, which allows it to be classified into risk categories. Blood tests check TSH, and if there is excess hormone, scintigraphy can identify a functioning nodule. Fine-needle aspiration is indicated only for nodules with suspicious features or above a certain size; it is quick, ultrasound-guided, and the collected material is analyzed by a pathologist.

How we treat it at Femi Saúde

Management depends on the nodule's classification. Benign, symptom-free nodules are simply monitored with periodic ultrasound, at intervals ranging from six months to a few years. Nodules that produce excess hormone can be treated with radioactive iodine or surgery. When the biopsy shows suspicious or malignant cells, the patient is referred for thyroid surgery, which generally has a very good prognosis. For large benign nodules causing compression, less invasive alternatives exist, such as radiofrequency ablation. In every situation, the endocrinology team at Femi Saúde explains the options and organizes follow-up.

What we offer