Choosing the right treatment for benign thyroid nodules

The article is professionally consulted by Master, Doctor Vu Thi Duyen - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Benign thyroid nodules are now common in women. When the patient has a lump in the neck that causes discomfort or even a large tumor that makes it difficult to breathe or swallow. Depending on the nature and extent of tumor growth, the patient should choose which treatment method is appropriate. Currently, there are 4 main treatment methods: medical, radiofrequency ablation of the thyroid gland if indicated, surgery and aspiration.

Benign thyroid nodules are solid or fluid-filled lumps (tumors) that form in the thyroid gland - a small gland located in the front of the neck, just above the breastbone.
Most thyroid nodules are benign with only a few around 5% being malignant. Usually glandular tumors of the thyroid gland such as thyroid cysts and multinodular goiters are benign tumors.

Before giving appropriate treatment, patients need to be clinically examined and do thyroid hormone tests, thyroid ultrasound, thyroid nodule aspiration to distinguish benign or malignant. These tests are used to determine the location, size, number, and nature of nuclei. For benign thyroid neoplasms, there are currently the following treatment methods:
2.1 Follow-up and periodic follow-up specialist appointments If the biopsy results show that the thyroid tumor is benign, the tumor size If the tumor is about 1-2cm small, the doctor can advise the patient to just monitor and re-examine periodically. This means that patients only need periodic follow-up visits for thyroid function tests and thyroid ultrasound to assess tumor progression. If the tumor is larger, then it is necessary to change the direction of treatment. In contrast, the benign thyroid tumor does not change in size, then no further treatment is required, only periodic monitoring.

2.2. Internal medicine With an average size of about 2-3 cm, thyroid hormone L-T4 can be treated for at least 6 months and then re-evaluate the results. The medication used is levothyroxine, a synthetic form of thyroxine in pill form. The extra supply of thyroid hormone signals the pituitary gland to produce less TSH (TSH is a hormone that stimulates the growth of thyroid tissue).
However, this therapy is still very controversial at present because there is no clear evidence to suggest that treatment with antithyroid drugs will shrink the size of the tumor. Therefore, during the treatment, it is necessary to monitor if the tumor is smaller in size, it will continue to be treated with drugs. On the contrary, if after treatment with drugs, the multiplication should be considered, stopping antithyroid drug therapy and switching to other treatment methods immediately.
2.3 Surgery With a large nodule over 4 cm or with many complications such as compression causing difficulty breathing or swallowing, a benign tumor has an indication for immediate surgery. Surgery may also be indicated in patients with large multinodular goiter, especially when the tumor causes constriction of the airways, esophagus, or blood vessels. Tumors that are diagnosed as unspecified or suspected malignancy also need to be surgically removed to make it easier to check for signs of cancer.
If they are fluid-filled cysts, they are usually benign, but if they are large (more than 4cm in diameter) they should also be operated on.
2.4. In the case of thyroid nodule is liquid (containing fluid), it is necessary to aspirate all the fluid. The patient was then pricked again for cytology. In 50% of cases, the cysts disappear on their own after a few times of aspiration.

In rare cases, benign thyroid nodules may decrease in size on their own. In the majority of patients, these nodules progress very slowly, requiring only regular monitoring.
Currently, the safest and most effective modern technique for treating benign thyroid tumors is High-frequency ablation, successfully applied in the treatment of benign tumors at Vinmec Times City International General Hospital. in patients with solid, large and benign tumors.
The hospital has a team of doctors who have been trained and worked for many years in the endocrinology industry. Includes:
Master. BS. Bui Minh Duc Dr. BS. Pham Thi Hong Hoa BS. Nguyen Van Phan Advantages of radiofrequency ablation at Vinmec Times City International Hospital to kill tumors with heat without surgery. This treatment method gradually shrinks the tumor size by heating effect caused by the friction of ions in the tissue under the action of high frequency alternating current, located in the range of sound waves. Over time, tumor size will decrease 30-50% volume after 1 month, 60-70% volume after 3 months, and >90% after 12 months of treatment.
It is relatively easy to detect, diagnose, and treat benign thyroid tumors. Whenever you find a lump in the neck area, you need to consult your doctor for specific instructions. However, do not worry too much because the rate of melanoma of the thyroid gland is relatively low.
Master. Doctor. Vu Thi Duyen has more than 10 years of experience in general medical examination and treatment, especially has strengths in examination and treatment specialized in nephrology - Endocrinology.
The doctor has participated in many domestic and foreign seminars and is currently a Nephrologist - Endocrinologist at the Department of General Internal Medicine, Vinmec Hai Phong International General Hospital.

In April & May 2021, when there is a need for examination and treatment of thyroid tumors at Vinmec Central Park International General Hospital and Vinmec Da Nang International General Hospital, customers will enjoy dual incentives :
- Free specialist examination and free X-ray
- Reduce 50% of the cost for customers with appointment of post-examination treatment. The program is limited to the corresponding technique of each hospital and to customers who perform this treatment technique for the first time at Vinmec.