How to determine the clinical benignity of thyroid nodules?
1. A single solid thyroid nodule in a child or adolescent has a higher likelihood of malignancy.
2. nodules, whether single or multiple, have the potential to become malignant, with the rate of malignancy being higher in single nodules than in multiple ones
3. sudden discovery of thyroid nodules within weeks or months with progressive enlargement or symptoms of pressure should be considered malignant.
4. thyroid ultrasound showing irregular borders, poorly defined circumference, incomplete envelope and uneven internal echogenicity of the nodule should be considered malignant.
5. thyroid nuclear scan: cold nodules, especially single ones, should be considered malignant.
6. thyroid needle aspiration cytology, which reveals the presence of cancer or moderate to severe atypical hyperplasia.
Those found to have calcified foci in the nodules during imaging should be listed as an indication category for surgery, as they have a higher likelihood of cancerous changes should be considered as cancerous nodules if any of the following conditions are present.
(1) A history of external radiation exposure to the cervical thorax. Those who have developed thyroid nodules thereafter.
(2) A thyroid nodule that has existed for many years. Sudden rapid growth. The mass becomes hard and irregular.
(3) Isolated nodules in the thyroid gland that are occasionally found to be hard. Fixed and not associated with pain.
(4) Thyroid nodules in adolescents in non-endemic goitre endemic areas, especially in children and adolescents under 14 years of age.
(5) A single thyroid nodule in an adult male; an isthmic nodule in a middle-aged man between 30 and 50 years of age.
(6) A single thyroid nodule with ipsilateral cervical lymph node enlargement; one of the multiple thyroid nodules with a particularly prominent, hard texture, accompanied by ipsilateral cervical lymph node enlargement.
(7) Asymmetric enlargement or mass of the thyroid gland itself with hoarseness or Homer’s syndrome.
(8) Unexplained enlarged and hard, fixed cervical lymph nodes.
(9) Metastasis of cancer from other sites with concomitant enlargement or pain in the thyroid gland.
(10) Thyroid nodules with facial flushing, prolonged diarrhea instead of purulent blood-like stools or decreased blood calcium, neck x-ray, ultrasound finding calcified strong.
(11) Enlarged cervical lymph nodes with metastatic cancer of the thyroid gland or lymph nodes confirmed by pathological section.
(12) A stellate scar in a part of the thyroid gland or adhesions in the anterior neck muscle during thyroid surgery.