Do thyroid nodules require surgery? Surgery is required if they become malignant

If you have a serious illness, you will need timely surgical treatment. However, do thyroid nodules require surgery? Generally, early thyroid nodules have no symptoms. If malignant changes occur, timely treatment is required. If it is benign, suppressive treatment can be adopted.

1. Nodules larger than 1.5 cm or with calcification require prompt surgery

When thyroid nodules appear, many patients experience great psychological stress, thinking that the nodules are equivalent to cancer, and they immediately go to the thyroid surgery department and ask the doctor to remove them.

Whether a thyroid nodule requires surgery depends on its size and whether it is calcified. If there is a possibility of malignancy, surgery should be performed as soon as possible.

2. The following measures can be taken for benign nodules:

1. Follow up those with enlarged lesions and perform re-puncture or direct surgery.

2. Thyroid hormone suppression therapy is ineffective in short-term treatment and should be continued for at least half a year. Premenopausal women and men can use higher doses (to suppress TSH to below 0.1mu/l) for suppression treatment for more than one year. If the nodule shrinks, the dosage of thyroxine can be reduced and taken for a long time to maintain TSH at the lower limit of normal. If the nodules enlarge, treatment will be stopped and surgery or re-puncture evaluation can be performed directly; if the nodules do not change, treatment will also be stopped and only follow-up observation will be performed. Postmenopausal women should pay attention to the adverse effects of thyroid hormone on bone metabolism. A short-term follow-up (6 to 12 months) should be conducted first. If the nodule does not change or shrinks, follow-up alone is sufficient and thyroid hormone suppression therapy is not necessary. If the nodule enlarges after follow-up, suppression therapy should be given again. Generally, the initial dose should be small enough to suppress TSH to a level below the normal but measurable range (0.1 to 0.5 mu/l).

3. Sclerotherapy for confirmed benign nodules. In particular, this method can be used to treat autonomous functional thyroid nodules or adenomas, parathyroid adenomas, etc. Under ultrasound guidance, 1 to 4 ml of anhydrous ethanol is injected into the center of the nodule. The injection can be repeated until the nodule disappears.