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Have Swollen Neck. Ultrasound Showed Large Nodule. Do I Need Surgery For Cure?

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Posted on Thu, 21 Feb 2013
Question: Nodules were found in my neck in August of last year. The largest one was 2cm on the left side and was biopsied. I was determined to be benign. Fast forward to present. Follow-up ulrtra-sound now shows a larte nodule on the right side. The right of my neck is swollen and I am hoarse.
Doc ordered a Thyroid Uptake Scan. Thyroid blood tests are normal. Whether cold or hot nodules are determined, do you think surgery will be recommended because of the size?
doctor
Answered by Dr. Rahul Tawde (9 hours later)
Dear XXXXXXX
Thanks for the query. If there are any sonographically suspicious features, biopsy is suspicious and not benign then surgery is indicated. Most benign nodules are cold as are malignant ones. So cold nodule doesnot mean anything as such. If there is a significant increase in size then decision is tilted towards surgery just to avoid the need for regular monitoring by sonogram and/or biopsy. Most of them turn out be benign on histopathology. So suspicious features on sonography or biopsy, presence of lymphadenopathy and increase in size tend to tilt the preference towards surgery although there arent any hard and fast rules. Many times physician and patient' preference determine the form of treatment -surgery vs follow up. So in your case yourdoc's assessment and preference as well as your opinion matter alot in final desicision unless surgery is absolutely indicated for valid reasons.
Hope this helps.
Shivaprasad
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Have Swollen Neck. Ultrasound Showed Large Nodule. Do I Need Surgery For Cure?

Dear XXXXXXX
Thanks for the query. If there are any sonographically suspicious features, biopsy is suspicious and not benign then surgery is indicated. Most benign nodules are cold as are malignant ones. So cold nodule doesnot mean anything as such. If there is a significant increase in size then decision is tilted towards surgery just to avoid the need for regular monitoring by sonogram and/or biopsy. Most of them turn out be benign on histopathology. So suspicious features on sonography or biopsy, presence of lymphadenopathy and increase in size tend to tilt the preference towards surgery although there arent any hard and fast rules. Many times physician and patient' preference determine the form of treatment -surgery vs follow up. So in your case yourdoc's assessment and preference as well as your opinion matter alot in final desicision unless surgery is absolutely indicated for valid reasons.
Hope this helps.
Shivaprasad