endocrine and metabolic disorders
Approach to the Patient With a Thyroid Nodule
Treatment of a Thyroid Nodule
Treatment of underlying disorder Treatment is directed at the underlying disorder ( Treatment reference ). Nodules in patients with Hashimoto thyroiditis or other causes of goiter associated with hypothyroidism may stabilize or shrink with thyroxine replacement in doses that render the patient euthyroid. For small benign nodules not associated with hypothyroidism, thyroxine suppression of TSH effectively shrinks the nodule in no more than half the cases, and is seldom done. Thyroxine is not used to treat Large benign nodules that compress the surrounding neck structures may become smaller following radiofrequency ablation. Partial or complete thyroidectomy are effective for treating nodules that continue to grow or cause compressive symptoms. Toxic nodules may be treated with radioactive iodine to control hyperthyroidism and reduce nodule size. Nodules that are not due to thyroid cancer, are not causing compressive symptoms and are not associated with either hypothyroidism or hyperthyroidism may be safely followed by periodic neck examination and, if there is suspicion of nodule growth, by repeat ultrasound evaluation. 1.Haugen BR, Alexander EK, Bible KC, et al: 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.Thyroid26(1): 1–133, 2016. doi: 10.1089/thy.2015.0020 