Thyroid nodules are common endocrine disorders, especially in women. Most cases are benign thyroid nodules, cause no symptoms, and are discovered incidentally during health check-ups or neck ultrasounds.

According to Doctor Nguyen Thanh Trung, Specialist Level II, from the Department of Oncology at Tam Anh General Hospital in Ha Noi, early recognition of unusual signs and timely examination aid in diagnosis and treatment.

Palpable lump in the front of the neck

This is the most common sign of thyroid nodules. Patients may detect a small lump in the front of the neck, just below the thyroid cartilage (Adam's apple), which moves with swallowing as the thyroid gland moves with the trachea and larynx.

Initially, the lump is often small and painless, leading many to overlook it. Over time, it grows larger, becoming noticeable when looking in a mirror, applying makeup, shaving, or wearing a necklace. Cases where the lump rapidly increases in size, feels hard, has irregular borders, or is accompanied by neck lymph nodes should be evaluated promptly with ultrasound and other appropriate diagnostic methods.

Difficulty swallowing or a choking sensation in the neck

As the lump grows larger, it can compress the esophagus or surrounding tissues, causing a feeling of difficulty swallowing, choking, or as if something is stuck in the throat. Symptoms are usually more pronounced when swallowing solid foods but can also occur when drinking water or swallowing saliva. Many people mistake this for pharyngitis or gastroesophageal reflux and attempt self-treatment.

If difficulty swallowing persists for many weeks, especially when accompanied by a lump in the neck, patients should seek specialist examination to determine the cause.

Doctor Thanh Trung explains thyroid ultrasound results to a patient. Illustration: Tam Anh General Hospital.

Persistent hoarseness

The thyroid gland lies close to the recurrent laryngeal nerve, a structure that controls vocal cord activity. When a lump invades or compresses this nerve, patients may experience hoarseness or voice changes. According to Doctor Trung, this sign warrants attention, especially if hoarseness lasts longer than 2-3 weeks and is not related to laryngitis or the common cold.

Hoarseness can suggest that a thyroid nodule has invaded or compressed the recurrent laryngeal nerve. However, this symptom is also present in many other benign laryngeal conditions.

Shortness of breath

Some large thyroid nodules or substernal goiters can compress the trachea, causing shortness of breath, a feeling of neck heaviness, or pressure in the front of the neck. Patients often feel more discomfort when lying on their back, bending their head, or during strenuous activity.

In the early stage, symptoms may be mild, but as the compression increases, patients may develop stridor, difficulty breathing, or persistent coughing.

Palpitations and rapid heartbeat

Some thyroid nodules can become overactive, independently producing thyroid hormones without the body's regulation, leading to hyperthyroidism. In such cases, patients may experience symptoms like palpitations, rapid heartbeat, tremors in the hands, weight loss despite normal or increased food intake, heat intolerance, excessive sweating, irritability, and insomnia.

To evaluate thyroid nodules, the treating doctor will order a thyroid ultrasound to determine their size, morphological characteristics, and risk stratification according to systems like Acr Ti-rads or Eu-Tirads. For nodules with suspicious malignant features or those reaching recommended size thresholds, patients will undergo fine-needle aspiration (FNA) to determine the nature of the lesion. Some cases may require additional thyroid function tests or other imaging diagnostic methods if tumor spread is suspected.

Early detection helps identify lesions with cancer risk, enabling the selection of appropriate treatment methods.

Hieu Nguyen