What is Thyroid Gland and Goiter? 

The thyroid gland is a butterfly-shaped organ in the neck, seated just above the trachea, consisting of right and left lobes. It ensures the secretion of T3 and T4 hormones in our body into the blood. These hormones are controlled by the hormones secreted from the brain known as TSH. The thyroid gland affects all organs in our body and regulates our metabolism.

What is goiter?

Goiter is the name given to the enlargement of the thyroid gland. This growth can be due to any disease. For example; We call any growth independent of the disease in the thyroid gland, including regional goiter due to iodine deficiency, which is also common in our country, goiter due to enlargement of nodules in the thyroid gland, growth caused by any type of thyroid cancer, “goiter”.

What is a Thyroid Nodule?

Thyroid nodule is the name given to the masses in the thyroid. These nodules formed in any way can be cancerous or harmless and are called thyroid nodules because they are located inside the thyroid gland. Thyroid nodules may be in one or more of both lobes of the thyroid. If the number is only one, it is called a single nodule, that is, a solitary nodule. If there is more than one nodule, it is called multiple nodule. Nodules may be only cystic or solid only. The distinction between them is decided by a doctor’s examination and ultrasound.

Why Does a Thyroid Nodule Occur?

Nodules formed in the thyroid gland are due to multiple causes. The most important of these is goiter disease, that is, nodules that occur as a result of iodine deficiency. These nodules can range from the size of a lentil to the size of an orange. Nodules in the thyroid gland, which appear on the neck, can grow towards the back of the rib cage as well as on the neck. It is not possible to find the nodule by measuring the dependence of thyroid nodules with thyroid hormone. In other words, it is not very accurate to decide on the presence of a thyroid nodule by measuring the thyroid hormone. When a thyroid nodule is detected, it is seen that these structures that occur most of the time are independent of thyroid hormone and at the level of normal thyroid hormones.

How is Needle Biopsy Performed in Thyroid Nodules?

Needle biopsy of thyroid nodules can be taken under or without ultrasound. Needle biopsy under ultrasound is the most valuable. First of all, the patient lies on his back and the nodule in the thyroid is found by ultrasound and local anesthesia is applied to the place where the nodule is. Then, the nodule in the thyroid is entered with a thin needle, and the cells are removed by going to the front and back several times in the area. These cells are then spread on a glass and given to the pathologist. The pathologist usually accompanies this process at that time. Pathologist; examines the cells under the microscope and makes the diagnosis at that moment if there is a cancerous cell.

How Are Thyroid Nodules Treated?

The treatment of thyroid nodules is decided according to the pathological results obtained by the needle biopsy, which will be performed according to the doctor’s examination and ultrasound results. It is also not necessary to perform a needle biopsy of every thyroid nodule. If the condition has been shown to be benign at certain rates on ultrasound, only follow-up is sufficient instead of needle biopsy. Their size is also important. In thyroid nodules smaller than 2 cm, if ultrasound follow-up criteria are also established, nothing is done, they are only followed. But if it is determined on ultrasound that the condition may be cancerous, a needle biopsy should be performed and the nodules should be treated according to the results of the needle biopsy. In those whose condition is benign, a follow-up procedure is applied, if it is above a certain size, such as 3 cm, surgery is required.

Which Thyroid Nodules Should Be Operated?

Surgery on thyroid nodules depends on multiple reasons. Most importantly, if a needle biopsy is performed when there is a nodule in the thyroid and this cancer is found, it is the primary reason for surgery. In addition, if any nodule in the thyroid has enlarged in a short time and surgery is required when looking at the growth rates, then surgery is also performed. Since childhood nodules carry a risk of cancer, they need to be operated. Surgery is still obligatory in patients who have undergone needle biopsy in any way and the tumor has not been removed, but has nodules larger than 3 cm.

What is Thyroid Cancer?

Thyroid cancers are cancers that arise within the thyroid gland. They usually arise from the nodules present in the thyroid. By revealing the nodules in a certain structure with ultrasound and examination, it is decided whether there is thyroid cancer. At the same time, some blood tests and their thyroid hormone levels are measured to reveal their links with thyroid cancer. However, it is not possible to diagnose thyroid cancer by measuring thyroid hormones. There are multiple types of thyroid cancers. These are cancers and can be of a very mild nature. But there are also very aggressive and fast moving ones. Usually thyroid cancers; It is among the diseases that have a benign nature and do not make the patient worse.

Who is at Risk of Developing Thyroid Cancer?

Patients at risk for thyroid cancer are usually women. One male thyroid nodule occurs versus six female thyroid nodules, while three females have thyroid cancer versus one male thyroid cancer. With this ratio, the risk of cancer is higher in nodules that occur in men. But overall, women have a higher risk of thyroid cancer. At the same time, thyroid nodules occurring in children are also at high risk. In childhood, radiation treatments to the neck increase the risk of thyroid cancer, but nowadays its use has decreased considerably. Genetic diseases also increase the risk of thyroid cancer. Some genetic disorders reveal specific types of cancers in the thyroid.

Is Thyroid Cancer Deadly?

Most thyroid cancers are silent. In other words, in elderly patients over a certain age, cancers in the thyroid that have remained completely silent and have not affected their body can be seen. There are also studies on this subject. When the thyroid glands of patients who died at a certain age for other reasons were examined, many thyroid cancers that did not spread to other organs and did not pose a danger were found. In addition, different types of thyroid cancers can progress very aggressively and rapidly. Therefore, they should be identified and what type they are.

How is Thyroid Cancer Diagnosed?

One of the most important methods when thyroid cancer is suspected is the doctor’s own examination. In other words, the structure of the thyroid gland, whether there is nodule in it, the mobility and stiffness of the nodules are determined and it is decided whether there is thyroid cancer, at least a suspicion is felt. The second method is imaging methods, and the most important one is ultrasound. Thyroid ultrasound gives more information than doctor examination methods. It gives information such as the structure of the mass, whether it is cystic, its relationship with the surrounding tissue, whether there is calcification in it. The most important diagnostic method is biopsy of the thyroid with a needle. A definitive diagnosis is made pathologically by needle biopsy of the thyroid. This is the most precise method.

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