Thyroid nodule

Causes and risk

The symptoms more suggestive of malignancy are a rapidly enlarging swelling and hoarseness of voice.

The risk factors are a family history of thyroid malignancy or syndromes; a history of radiation exposure especially during childhood, or living near nuclear factories; male gender; age extremes; full body radiotherapy; and the syndromes Gardeners, Cowdens, Corney's and chromosomal translocation.

How it presents

Usually a solitary nodule palpated in the thyroid on routine physical examination, in a patient who denies pain, dysphagia, hoarseness and hemoptysis, and denies fatigue, weight change, heat or cold intolerance, diarrhea or constipation, with no family history of thyroid cancer. The history has to cover compressive, invasive and constitutional symptoms, and hyper or hypothyroid symptoms. A normal TSH does not end the evaluation.