An enlarged thyroid gland can be felt as a lump under the skin at the lower part of the neck. When thyroid is large enough to be seen easily, it is called goitre. This visible swelling can be the entire gland or part of the gland. An isolated enlarged area or a lump in the thyroid gland is called a thyroid nodule. Nodules may be solid, filled with fluid or partly fluid and solid.
If the thyroid gland cannot produce enough hormone, it compensates by increasing in size and becoming a visible swelling in the neck. This usually happens in places where iodine is deficient in the diet. Sometimes other conditions like autoimmune thyroiditis can cause swelling of the thyroid gland. In rare situations tumors of the thyroid gland can cause swelling.
Thyroid nodule presents as a lump in the lower part of the neck which moves up and down when a person swallows. It may affect one lobe of the thyroid gland. There can be multiple nodules affecting the entire gland.In case of very huge thyroid swellings, there may be difficulty in swallowing and breathing because of pressure exerted by the swelling of the food pipe and windpipe.
All thyroid swellings are not cancers. Only 5 to 15 percent are cancers or have the potential to be cancerous. Sudden increase in size of an existing thyroid nodule could indicate something serious.
Treatment options depend on what is the type of thyroid nodule. In benign thyroid nodules, most of the time you don’t need any treatment. If the patient is hypothyroid and is treated medically, the enlarged gland may shrink to normal size. Huge benign nodules or goitres with windpipe and food pipe compression may need surgery to relieve pressure. Cancers of thyroid usually need total thyroidectomy with or without neck dissection depending on the type of cancers. Majority of thyroid cancers are slow growing and are associated with good prognosis.
Only in case of thyroiditis a patient may present with neck pain, tenderness in the lower part of neck and throat pain. This is due to inflammation of the gland. Most of the time thyroid nodules are painless and are picked up during evaluation for other conditions.
A low iodine diet is usually prescribed for patients suffering from hyperthyroidism. But only a dietary modification may not cure the disease. Conversely in hypothyroidism an iodine rich diet is advised but may require thyroxine hormone replacement. Only dietary modification alone cannot cure these conditions.