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Shawn Ciecko MD: The Diagnosis and Treatment of Thyroid Nodules

09/15/2010 in news

Sometimes the thyroid gland grows larger than normal, causing a condition known as goiter

By Dr. Shawn C. Ciecko

Staten Island Advance

STATEN ISLAND, N.Y. -- The thyroid gland is an endocrine gland located in the neck just below the Adam's apple. The thyroid is responsible for the regulation of the body's metabolic rate and is involved in fetal growth, including fetal brain development.

The thyroid gland accomplishes this by releasing thyroid hormone. This hormone is regulated by the release of TSH (thyroid stimulating hormone) from the pituitary area of the brain. A feedback mechanism occurs when a body has enough thyroid hormone circulating through it, stopping the release of TSH.

While many people suffer from an over functioning thyroid gland (hyperthyroidism) or an under functioning gland (hypothyroidism), others suffer from nodules or enlargement of the gland that doesn't affect its function. These patients often have normal thyroid lab values with thyroid nodules or a thyroid goiter.

Sometimes a lump or nodule is noted within the thyroid gland. This is often noticed by the primary doctor or the patient. When a nodule is suspected, the patient should have a thyroid ultrasound (or thyroid sonogram) performed to thoroughly evaluate the entire thyroid gland and make specific measurements of the nodule.

In addition, all patients should have thyroid function tests to see if their gland is functioning normally. Most patients will be evaluated next by an endocrinologist (physician who handles glandular disorders) or an endocrine surgeon (an ear nose and throat/head and neck surgeon or a general surgeon with special training in thyroid surgery).

Upon examination, some patients are diagnosed with a condition termed goiter. A thyroid goiter is an abnormally enlarged thyroid gland. An enlarged gland may be functioning normally or may even have low function. Goiters can also have thyroid nodules, and when multiple nodules are seen, it is termed a multi-nodular goiter.


In 2006, the American Thyroid Association Task force was organized to define a set of guidelines to manage thyroid nodules. The goal of this task force was to identify patients who were at risk for having thyroid cancer in their nodules. Thyroid nodules are very common and well-differentiated thyroid cancers (papillary carcinoma/follicular carcinoma/hurtle cell carcinoma) are treatable cancers....

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