Goiters and Thyroid Nodules

It can take months or years for a goiter to develop. In teens, goiters are usually caused by the autoimmune thyroid conditions discussed above, which might show no obvious symptoms until the goiter is visible as a swelling at the front of the neck. People with this problem might have the sensation that food is stuck in the throat, especially when they lie down or sleep on their backs.

Generally, treatment of the thyroid disease causing the goiter will decrease or control the enlargement. If the thyroid continues to get larger despite treatment and becomes large enough to cause discomfort or a lump in the neck, surgery may be required. However, surgery is not necessary for most people.

A thyroid nodule is a lump or enlarged area in the thyroid gland. Sometimes a nodule can appear in a healthy gland. It may feel like a lump in the throat, or there may be tenderness or pain in the front of the neck. If the nodule is large enough, it may be visible at the front of the neck.

Most thyroid nodules are harmless. A nodule may simply be an overgrowth of normal thyroid tissue, a swelling caused by inflammation (such as in autoimmune thyroid diseases) or a collection of fluid called a cyst.

The doctor usually discovers nodules by touch during a physical examination. If the doctor finds a nodule, blood tests might be needed to find out how the thyroid gland is working. A doctor may also take an ultrasound image of the gland to detect whether the nodule is a cyst or a solid growth or tumor.

In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called themedical history.

Another test called a thyroid scan can tell the doctor what type of nodule a person has. For this test, a person swallows a pill containing a small amount of radioactive iodine or another radioactive substance. The thyroid absorbs the radioactive substance. Next, a special camera measures where the radioactive substance is taken up by the thyroid gland, giving the doctor a better picture of the location, size, and type of thyroid nodule.

In addition, a fine-needle biopsy may be done to help determine whether a nodule is cancerous. During the biopsy, the doctor inserts a thin needle through the skin into the thyroid nodule (the skin is numbed with medication first). Through the needle, the doctor takes a sample of tissue or some fluid from a cyst. The tissue or fluid is then sent to a lab to be examined. In some cases, a person might need to have the nodule surgically removed for more detailed examination in the lab.

Fortunately, cancer is rare in children and teens, and most thyroid cancers can be cured or controlled with treatment.