The thyroid gland consists of two lobes, one on each side of the windpipe, connected by a small bridge of thyroid tissue called the isthmus. It is located in the front of the neck just above the breastbone and below the Adam's apple. An important part of the endocrine system, the thyroid is a hormone-producing gland that regulates metabolism—the rate at which the body produces energy from nutrients and oxygen—and affects body functions, such as energy level and the heart rate.
Otolaryngologists from Brigham and Women’s Division of Otolaryngology at Brigham and Women's Faulkner Hospital offer a comprehensive, multidisciplinary approach to caring for patients with thyroid nodules and thyroid cancer. We specialize in minimally invasive surgery techniques such as lobectomy and thyroidectomy.
A multinodular thyroid goiter or toxic nodular goiter (enlargement of the thyroid gland) can become very large so that it can easily be seen as a mass in the neck. Hyperthyroidism caused by toxic nodular goiter is a condition in which one or more nodules of the thyroid becomes overactive. Symptoms of multinodular goiter do not include bulging eyes or skin problems, as in Graves' disease. The cause of toxic nodular goiter is not known.
Surgery may be required if the goiter does not improve and is causing problems, such as pain or difficulty swallowing or speaking.
Thyroid tumors are either benign (noncancerous) or malignant (cancerous) growths. Examples of benign tumors are adenomas, which may secrete thyroid hormone. Malignant tumors are rarer and are more common in women than in men. According to the American Cancer Society (ACS), more than 56,000 cases of thyroid cancer are diagnosed every year in the United States.
Thyroid adenomas are small nodules (or growths) that start in the cell layer lining the inner surface of the thyroid gland. The adenoma itself may secrete thyroid hormone. If the adenoma secretes enough thyroid hormone, it may cause hyperthyroidism. Thyroid adenomas may be treated if they cause hyperthyroidism. Treatment may include surgery to remove part of the thyroid (the overactive nodule).
Cancerous tumors of the thyroid occur more often in people who have undergone radiation to the head, neck, or chest. However, it may occur in people without any known risk factors. Thyroid cancer usually appears as nodules within the thyroid gland. Some signs that a nodule may be cancerous include:
Presence of a single nodule rather than multiple nodules
Thyroid scan reveals the nodule is not functioning
Nodule is solid instead of filled with fluid (cyst)
Nodule is hard
Nodule grows fast
The first sign of a cancerous nodule in the thyroid gland is usually a painless lump in the neck. Other symptoms may include:
A painless lump in the neck
Hoarseness or loss of voice as the cancer presses on the nerves to the voice box
Difficulty swallowing as the cancer presses on the throat
Throat or neck pain that does not go away
A cough that does not go away
However, the symptoms of thyroid cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
You will receive a thorough diagnostic examination to evaluate if you have a thyroid condition and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced otolaryngologist are important to the successful outcome for patients with ear, nose and throat disorders and conditions.
If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.
The day of surgery, you will be taken care of in the operating room by otolaryngologist, anesthesiologists and nurses who specialize in surgery for patients with thyroid conditions. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by experienced surgical and nursing staff.
Brigham and Women’s Faulkner Hospital provides a multidisciplinary approach to patient care by collaborating with colleagues who have extensive experience in diagnosing and treating ear, nose and throat disorders and conditions. In addition, patients have full access to Brigham and Women's Hospital's world-renowned academic medical community, with its diverse specialists, and state-of-the-art facilities.