[vc_row][vc_column][vc_column_text]<\/p>\n
\u0395\u03ba\u03c4\u03cd\u03c0\u03c9\u03c3\u03b7<\/span><\/a><\/p>\n [\/vc_column_text][vc_tta_accordion color=”sky” c_icon=”chevron” active_section=”1″ no_fill=”true” collapsible_all=”true”][vc_tta_section title=”What Are Thyroid Nodules” tab_id=”1615975356574-814f1578-a50b”][vc_column_text]Thyroid nodulesdevelop within the thyroid gland, located at the base of the neck. Their<\/span> size<\/b> can range from a few millimeters to several centimeters. Morphologically, they are \u201cprotrusions\u201d of the gland and can be either <\/span>solid or cystic<\/b> (containing fluid). Simply put, small nodules can be compared to hazelnuts embedded in a chocolate bar. Nodules may appear as a<\/span> single nodule<\/b> or as part of a <\/span>multinodular goiter.<\/b>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”How Common Are Thyroid Nodules” tab_id=”1615975356596-08586a48-adda”][vc_column_text]Thyroid nodules are extremely common, with estimates suggesting that <\/span>up to 50% of the population may develop them.<\/b> They occur more frequently in women and are more often<\/span> benign than malignant.<\/b> Most nodules are not visible or palpable and are usually discovered incidentally during an ultrasound. <\/span>In most cases, thyroid hormone levels remain normal despite the presence of nodules.<\/b>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What Are Hot and Cold Thyroid Nodules” tab_id=”1615975445991-abbe6e0b-76e0″][vc_column_text]If<\/b> a thyroid scintigraphy is performed (which is not always necessary), nodules may appear as <\/span>\u201chot\u201d<\/b> (overactive) or <\/span>\u201ccold\u201d<\/b> (underactive). Cold nodules carry a <\/span>higher risk of malignancy,<\/b> although hot nodules are not entirely risk-free.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What Are the Causes of Thyroid Nodules” tab_id=”1615975481588-25200828-4edd”][vc_column_text]Modern medicine has not fully clarified the exact mechanisms behind nodule formation. Certain recognized factors include:<\/span><\/p>\n [\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What Are the Symptoms of Thyroid Nodules” tab_id=”1762173024473-a272b0a5-b2ac”][vc_column_text]In the vast majority of cases, <\/span>thyroid nodules cause no symptoms and are painless<\/b>, often growing silently.\u00a0<\/span><\/p>\n Symptoms may occur if nodules exert pressure on nearby structures:<\/span><\/p>\n If nodules cause hyperthyroidism, symptoms may include:<\/span><\/p>\n When thyroid nodules start causing noticeable symptoms, the disease is no longer at an early stage, and prompt intervention is required.<\/b>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”How Are Thyroid Nodules Diagnosed” tab_id=”1762173135402-a9a03df8-2900″][vc_column_text]Beyond medical history and clinical examination of the neck, <\/span>the thyroid ultrasound is the gold-standard diagnostic tool.\u00a0<\/b><\/p>\n Ultrasound evaluates the nodule\u2019s size, composition (solid or cystic), relation to surrounding structures, suspicious features for malignancy, and presence of abnormal lymph nodes.<\/span> Elastography <\/b>may also be performed to assess nodule stiffness and potential malignancy. Further evaluation is performed with <\/span>fine-needle aspiration (FNA)<\/b> of the nodule.<\/span><\/p>\n Additionally, <\/span>hormonal tests<\/b> are carried out (TSH, T3, T4, Tg, Anti-TG, Anti-TPO, Calcitonin), and in certain cases, a thyroid scintigraphy, CT or MRI scans, PET scan, etc., may be requested.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What does nodule puncture do” tab_id=”1615975590436-b57265fb-fab9″][vc_column_text]Fine Needle Aspiration (FNA) biopsy is a technique that was first described in Sweden, almost half a century ago, for the evaluation of swellings in the thyroid gland. It is based on the\u00a0<\/span>removal of cells from the thyroid via the needle<\/b>, with or without local anaesthesia, and their further examination under a microscope.<\/span><\/p>\n The findings of the examination may be characterized as benign, malignant, suspect of malignancy or insufficient for diagnosis.<\/span><\/p>\n Fine Needle Aspiration is a frequently used method for examining thyroid nodules,\u00a0<\/span>providing important information<\/b>, however the information as to whether we have to do with a benign nodule or cancer\u00a0<\/span>is based on the examination of a very small sample of cells and cannot offer us the certainty<\/b>\u00a0that the neighbouring cells are not cancer as well.<\/span><\/p>\n I have had one or more fine-needle aspirations (FNA) that showed benign results. Can I safely assume that I do not have cancer<\/b><\/p>\n Punctures suck out a small number of cells from specific points of the nodules and usually it is the larger nodules that are punctured because this is easier for the one performing the examination.<\/span><\/p>\n Very often however, patients with one or many \u201cclean\u201d pre-surgical fine needle aspiration biopsies, do have, in the end, after the surgery, a biopsy positive for cancer<\/b>. This is explained by the needle finding itself just a few millimetres beside the cancerous focus and the correct diagnosis failed to be made.<\/span><\/p>\n Therefore,<\/span>\u00a0the F.N.A. result has simply indicatory and not proving value. The certainty that there is cancer or not can only be provided by a biopsy of a thyroid that has been excised and examined.<\/b>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”My Nodule Remains at roughly the Same Size, can I rest easy” tab_id=”1615975556038-9e4b248f-329d”][vc_column_text]A nodule, even one only a few millimeters in size, contains millions of cells. Leaving a pathological focus (nodule) in the body, which may not have significantly decreased or disappeared despite treatment, allows for the possibility of malignant transformation at any time.<\/span><\/p>\n The transformation of a nodule from benign to malignant typically does not cause symptoms and usually does not affect thyroid hormone tests.<\/b><\/p>\n The size of a nodule does not constitute a defining criterion to diagnose malignancy.<\/b>\u00a0Some of its ultrasound characteristics, such as the calcifications, the boundaries, the vascularity and in general the morphology of a nodule may be grounds for suspicion of neoplasia.\u00a0There are many patients that decided to undergo surgery due to a large (e.g. 2.5 cm) nodule and in the end the biopsy \u201cabsolved\u201d the large nodule, but found multiple cancerous foci in other, seemingly insignificant, of few millimetres, nodules.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Do Thyroid Nodules Shrink on Their Own” tab_id=”1615976016751-0a946bcb-71fc”][vc_column_text]Thyroid nodules <\/span>usually do not resolve or shrink on their own,<\/b> as the underlying cause remains active throughout life. Even when serial ultrasounds appear to show a nodule has decreased in size, this is often due to slight differences in probe placement by the operator rather than a true reduction.<\/span><\/p>\n Thyroid nodules are established lesions that are not expected to disappear spontaneously. Fluctuations in size may occur due to changes in the fluid (colloid) they may contain, while the solid component persists and usually grows.<\/span><\/p>\n Their presence requires regular medical monitoring or definitive removal.<\/span><\/p>\n Dr. Evangelos Karvounis, MD, PhD, FACS<\/b>, is an award-winning <\/span>endocrine surgeon<\/span><\/a>, Doctor of the Medical School of the University of Athens and Fellow of the American College of Surgeons.<\/span>\n
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\n<\/span>With <\/span>extensive experience, specialized training in robotic surgery<\/b>, and a rich research and publication record, he can answer all your questions about <\/span>thyroid nodules<\/b>, including <\/span>when they may be malignant <\/b>and how they are treated.<\/span><\/p>\n