Thyroid Nodules and their Evaluation

Contents of This Page

Symptoms of a Thyroid Nodule
Evaluating a Nodule and Diagnosing Cancer
For More about Thyroid Nodules and their evaluation 

Symptoms of a Thyroid Nodule

  • Thyroid nodules are very common. Most are benign (not cancerous).
  • Less than 5% of thyroid nodules in adults are cancerous.  In children, 20% to 30% of thyroid nodules are proven to be cancerous.
  • Thyroid cancer is usually painless and without symptoms in its early stages.
  • Unless there is an obvious neck mass that can be seen, most nodules are detected by chance during a routine physical examination or during a doctor visit for an unrelated purpose.
  • Some symptoms that may appear include:
    • Hoarseness that has no known cause and does not go away
    • Difficulty breathing or shortness of breath
    • Difficulty swallowing or an unusual sensation (a “lump”) when swallowing
    • Nodule (lump) or growth in the neck
    • An abnormally large lymph node (a “swollen gland”) that fails to spontaneously shrink over a few months' time

Return to top of page

Evaluating a Nodule and Diagnosing Cancer

Steps in evaluating a thyroid nodule may include:

  • Physical examination. This should include a laryngeal exam (checking the vocal cords).
  • Neck ultrasound
  • Fine needle aspiration (FNA) biopsy, often under ultrasound guidance
  • Thyroid function lab tests—blood tests
  • Chest X-ray
  • CT (computerized tomography) without iodine contrast—or other imaging techniques
  • Thyroid scan with low-dose radioactive iodine or technetium
  • Other blood testing involving molecular markers, for patients with indeterminate thyroid nodules

Return to top of page

Points to keep in mind:

  • Your doctor will determine the diagnostic tools to use for you. Don’t hesitate to ask questions about the merits of each tool.
  • The fine needle aspiration (FNA) is the most reliable way to determine whether a nodule is benign, definitely cancerous, or possibly cancerous.
  • The FNA cannot always determine whether cancer is definitely present. In this situation, the tissue analysis after thyroid surgery is used to determine the diagnosis.

For More about Thyroid Nodules and their evaluation, go to

Return to top of page

Last updated: May 19, 2013