Philip A. Pollice, MD, FACS
Otolaryngologist, Metropolitan ENT Associates–UPMC
Patients come to see me often with thyroid nodules or what I refer to as lumps or bumps of the thyroid, and the most common symptom associated with that is often nothing at all. Patients will go to see their family doctors and a lump or a bump will be discovered in their neck via a routine examination. These lumps and bumps can often be discovered with other testing that’s done for other reasons, so that testing can be an ultrasound or a CT scan of the neck, and those tests may be done for a completely different reason but discover a thyroid nodule. Patients across the nation, many, many of them have thyroid nodules, and it’s a very common disorder. It seems to be much more common in women at about five times the rate that it’s seen in men.
Patients that have thyroid nodules are best worked up, or best evaluated, by using an ultrasound, which is a very sophisticated tool that can evaluate a thyroid nodule in a noninvasive way. It’s a painless procedure that gives us a great deal of information. It can tell us the size of the thyroid nodule and give us some idea about its character and characteristics. What we know is that nodules that exceed a centimeter in size or a little bit bigger than half an inch tend to be nodules that require further evaluation, and that further evaluation is typically something called a needle biopsy. That needle biopsy will give us an estimate of how likely that nodule is to be cancer and will help us decide whether or not that nodule can be followed, monitored over time with serial exam or ultrasound, or whether that nodule would require some sort of surgical procedure to better find out what it is.
Treating Thyroid Nodules
The treatment for thyroid nodules that have suspicious needle biopsies is surgery. The thyroid itself looks like a butterfly: it has a wing on the left and a wing on the right connected together by a body called the isthmus. When the nodule is suspicious, that wing of the thyroid will often need to be removed and be evaluated under the microscope to determine whether or not it is cancer. If indeed it is cancer, the other wing of the thyroid often needs to be removed. And following that, depending upon the level of cancer that the patient has, iodine treatments in the form of radioactive iodine will be used as a treatment to further eradicate any potential thyroid disease or thyroid cancer that persists in the body.
At Metropolitan ENT Associates–UPMC we offer comprehensive thyroid care. We have both expertise and experience in thyroid disease and thyroid surgery. Through our offices and through UPMC facilities, we are able to offer some of the most sophisticated diagnostic tools and treatment protocols available for thyroid disorders, and lastly we coordinate care amongst the family doctors and other medical specialists, including endocrinologists.
For more information, contact us at 724-772-2711 or toll-free 1-866-929-6368.