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Thyroid Masses Not Often Cancerous

Physicians paying more attention to thyroid conditions

The thyroid is a butterfly-shaped gland in the neck, located just above the collarbone. It is an endocrine gland that makes hormones. The thyroid helps set the body’s metabolism and regulates how the body gets energy from food.

Millions of people in the United States have thyroid disease. More women than men have thyroid disease. Having thyroid disease results in hypo- or hypermetabolism in the body.  Hypothyroidism is far more common than hyperthyroidism. Hypothyroidism can make a person gain weight, feel fatigued and have difficulty dealing with cold temperatures. Too much thyroid hormone can make patients lose weight, speed up the heart rate and make them very sensitive to heat.

There are a number of problems associated with the thyroid, and physicians these days are being more astute about looking for and addressing them.

“If a patient were to come in with a lump in the thyroid, we would do an ultrasound as the first step,” said Dr. Peter Tate. “If it is a cyst, which means there is fluid in there, it can be aspirated.”

A nodule is a solid mass, and most thyroid masses are solid. The physician would needle-aspirate the nodule and send the tissue for cytologic evaluation. “If it’s suspicious, then you need to do surgery,” Tate said.

Thyroid masses do not usually interfere with anything in the vicinity of the gland. “It’s rare that a mass grows and interferes with anything,” Tate said. “It has to be very large before it can cause a problem in the neck. Most of the time, the normal thyroid can’t be felt at all. If you start to feel your thyroid, that means it’s probably big and it may be a goiter.”

According to the American Thyroid Association (www.thyroid.org), the presence of a goiter does not necessarily mean the thyroid gland is malfunctioning. A goiter can occur in a gland that is producing too much hormone (hyperthyroidism), too little hormone (hypothyroidism) or even the correct amount of hormone (euthyroidism). A goiter indicates there is something causing the thyroid to grow abnormally. One of the most common causes of goiter formation worldwide is iodine deficiency, but this is not as large a problem in the United States as it was in the past.

Very rarely does a lump in the thyroid become malignant, Tate said. “Only about 10 percent of thyroid lumps are malignant,” he said. The lumps are relatively easy to take care of.

“You would do the biopsy, and if the lump is benign, you pretty much don’t have to do anything unless it gets really large,” Tate said. “If that happens, then you go to surgery and take it out.”

It is possible to live without a thyroid by taking hormone replacement medication. “All you have to do is take the medicine and you’ll be fine,” Tate said.

By Tanya J. Tyler, Associate Editor

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