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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is it necessary to remove the thyroid nodules?

Hi, I'm 40 year old female. My ENT doctor found a 4cm thyroid nodule on one side. A fine-needle test has been done and the results benign. The nodule does not cause any discomfort whatsoever. In fact, I had no idea it was there until this check-up. My ENT doctor advised that there is therefore no need to remove it. However, when I do a search on the internet, it seemed most doctors recommend removal of benign thyroid nodules so long as it is 3cm or more. I also came across many accounts of people with benign nodule who choose to remove such nodules only to find out that there were in fact cancerous tissues or smaller cancer nodules! I am at a lost as I know there are risks in removing thyroids (eg. damage to vocals, etc) and long term repurcussions (eg. taking pills for good...which may damage liver!). Do I take my doctor's advice and just do nothing? Your kind advise is most appreciated. Thank you.
Tue, 14 Jun 2016
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Endocrinologist 's  Response
Welcome and thank you for asking!
I have gone carefully through you query and i can understand your situation.
The recent guidelines recommend to do thyroidectomy when the nodule causes compression symptoms, the FNA result is suspicious or shows a malignancy, when the ultrasound characteristics are suspicious or when cervical lymph nodes are present.
The FNA sensitivity is high (>90%) anyway, there is still a risk that it may be false negative. That is why the ultrasound characteristics of the nodule are taken into consideration.
So, if you where a patient in my clinic i would decide to do thyroidectomy or not, in basis of the ultrasound characteristics.
Hope i was clear and feel free to ask again if you have still any query.
Kind regards,
Dr.Mirjeta

So, i would recommend you to do a thyroid ultrasound
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Is it necessary to remove the thyroid nodules?

Welcome and thank you for asking! I have gone carefully through you query and i can understand your situation. The recent guidelines recommend to do thyroidectomy when the nodule causes compression symptoms, the FNA result is suspicious or shows a malignancy, when the ultrasound characteristics are suspicious or when cervical lymph nodes are present. The FNA sensitivity is high ( 90%) anyway, there is still a risk that it may be false negative. That is why the ultrasound characteristics of the nodule are taken into consideration. So, if you where a patient in my clinic i would decide to do thyroidectomy or not, in basis of the ultrasound characteristics. Hope i was clear and feel free to ask again if you have still any query. Kind regards, Dr.Mirjeta So, i would recommend you to do a thyroid ultrasound