When A Worrying Growth Appears

While a thyroid lump on the neck isn’t usually life threatening, it can be a sign of a malignant tumour, which needs to be checked and operated on early.

The thyroid is a gland located at the front of the neck and secretes a hormone that controls the way the body utilises energy and heat; maintaining the normal functions of the brain, heart, muscles and organs.

Nodules, however, can develop in the thyroid, especially with age, causing it to become enlarged. This leads to conditions like multinodular goitres, which can present as lumps in the neck.

In other thyroid conditions like hyperthyroidism, there may be a variety of signs and symptoms such as weight loss, nervousness, irritability, intolerance to heat, excessive sweating, hand tremors, palpitations and muscle weakness. Bulging eyes and even double vision can occur.

Most are non-cancerous and are usually due to:

• Multinodular goitre
• Hyperthyroidism, such as Graves’ thyrotoxicosis
• Benign thyroid tumours such as adenomas
• Solitary thyroid nodule
• Autoimmune or inflammatory thyroid disorders, such as Hashimoto’s thyroiditis
• Iodine deficiency
• Physiological thyroid gland enlargement in pregnancy

But it can be difficult to tell if a thyroid tumour is benign or malignant, especially when some lumps are small and painless. “A thyroid lump might be cancerous if it continues to grow and if there are enlarged lymph nodes in the neck,” he says. “The patient can have hoarseness due to impairment of vocal cord function and may also have difficulty swallowing.”

Prof Goh says that thyroid cancers occur more frequently in women than in men, and those with a family history of medullary thyroid cancers have a higher risk of developing this cancer. For certain thyroid cancers such as follicular cancer, the risk is higher in people who have a diet low in iodine.

Exposure to radiation, too, for example those who have had previous radiation to the neck for other head and neck cancers, also presents risk. This is particularly so if the exposure happens at a younger age or during childhood.

“Because it is not always easy to tell if the condition is benign or malignant, it is important to get a thyroid lump checked to ascertain if it is indeed cancerous,” says Prof Goh, adding that investigations of a thyroid nodule would consist of thyroid ultrasound, fine needle aspiration biopsy and a thyroid function test.