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Solitary thyroid nodules are more common in females yet more worrisome in males. Other associations with neoplastic nodules are family history of thyroid cancer and prior radiation to the head and neck. Solitary thyroid nodules are mostly benign colloid nodules. The second most common type is follicular adenoma. [25]
Most people with thyroid cancer do not have symptoms at the time of diagnosis and thyroid nodules and thyroid cancer is usually found incidentally on imaging of the neck. [ 10 ] [ 14 ] Up to 65% of adults have small nodules in their thyroids, but typically under 10% of these nodules are found to be cancerous. [ 15 ]
Thyroid nodules that are detected by an imaging study but have not been previously detected or suspected clinically are considered to be ITNs. ITNs are one of the most common incidental findings on neck imaging. ITNs are reported in up to 25% of chest CT scans, and in 16–18 % of cervical region cross-sectional imaging, including CT and MRI scans.
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2]
Other clinical signs that could indicate papillary thyroid are fixation to the trachea, a firm neck mass, damage to recurrent laryngeal or cervical sympathetic nerves. Five percent of the population can have thyroid nodules, and the majority will be benign. [6] Appropriate workup includes an ultrasound of the neck, followed by lab studies.
Colloid nodules may be initially identified as an unspecified kind of thyroid nodule. Follow-up examinations typically include an ultrasound if it is unclear whether or not there really is a nodule present. Once the presence of a nodule has been confirmed, the determination of the kind of thyroid nodule is done by fine needle aspiration biopsy. [7]