[Medical Q&A] Do all thyroid nodules require surgery?

Planner: Chinese Medical Association

Reviewer: Liu Yuewu, Chief Physician, Peking Union Medical College Hospital

Not all thyroid nodules require surgery.

The nature of thyroid nodules may be nodular goiter, or granuloma, thyroiditis, thyroid tumor or thyroid cancer. Before they are characterized, they are collectively referred to as thyroid nodules. Size is not the only indicator of whether thyroid nodules need surgery. Although some nodules are only 0.8 cm in diameter, if they have a tendency to be malignant, they need to be removed as soon as possible. If the nodule is benign from ultrasound, then it will be considered for removal only when the nodule reaches 3 to 4 cm. If the color ultrasound indicates that it is a thyroid adenoma, it is also best to surgically remove it, because 10% of thyroid adenomas will become cancerous during their growth.

Multiple thyroid nodules generally require surgery only when their diameter is large enough to cause neck disfigurement, tracheal compression, or symptoms of hyperthyroidism. This is because nodular goiter is prone to recurrence after surgery, and due to adhesions after surgery, the probability of reoperation causing recurrent laryngeal nerve damage will increase significantly, which can lead to hoarseness.