Thyroid tumor: How to diagnose benign - malignant tumor?

The article was professionally consulted by Doctor Vu Thi Duyen - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Symptoms of thyroid tumors often develop quite silently, most are detected through ultrasound and routine physical examination. Therefore, in order to accurately diagnose the cause of the tumor, it is necessary to do some more tests. Regardless of whether a tumor is benign or malignant, the location, size, and nature of the tumor must be clarified.

The doctor will directly examine the thyroid gland to determine the location of the thyroid tumor in the neck. The patient will be asked to perform a swallowing motion, the tumor in the thyroid gland will move up and down as the patient swallows. The doctor asks and detects symptoms of hyperthyroidism, such as hand tremors, hyperreflexia, tachycardia or arrhythmias, as well as symptoms of hypothyroidism such as bradycardia, dry skin, and facial swelling.

A quantitative test of the hormones secreted by the thyroid gland in the blood are thyroxine, triiodothyronine (T3, T4) and thyroid-stimulating hormone (TSH) (released by the pituitary gland). This test can tell if the thyroid is producing too much thyroxine (hyperthyroidism) or too little (hypothyroidism).

Thyroid ultrasound uses high-frequency sound waves instead of radiation to create images. Ultrasound is used to determine the shape, size and structure of small tumors, to distinguish cystic structures from solid tumors, or to determine the presence of multiple nodules in the thyroid gland. In addition, ultrasound is used as a tool in performing fine-needle core biopsies.

Fine needle aspiration cytology of the thyroid tumor is used to determine the presence or absence of abnormal cancer cells. This method also helps differentiate benign from malignant thyroid nodules. The doctor will insert a very fine needle into the tumor and take a sample of cells. The procedure takes about 20 minutes, the risk of complications is very low. Currently, in this method, the doctor will aspirate under the guidance of ultrasound to help guide the needle placement. The aspiration biopsy samples are then sent to a lab and analyzed under a microscope.

To further confirm the substance of the thyroid tumor, the doctor may do a thyroid scan. The scan is done as follows: A radioactive isotope of iodine is injected into an arm vein, while a special camera scans it to create an image of the thyroid gland on a computer screen.
Tumors that produce foreign thyroid hormones (nodules) will appear on a scan because they take up more isotopes than normal tissue. Cold nodules appear as defects or holes during the scan. Most hot nodules are benign, while cold nodules are potentially cancerous.
The disadvantage of thyroid scintigraphy is the inability to distinguish between benign and malignant nodules. Thyroid scan time varies, depending on how long it takes for the radioisotope to reach the thyroid. The person being examined may experience neck discomfort as the scan is prolonged and will be exposed to small amounts of radiation during the thyroid scan.
After being confirmed as a benign tumor, patients with benign thyroid nodules have the option of gentler treatment without surgery such as radiofrequency ablation. After one month, the tumor volume is reduced by 30-50% and after one year it will decrease by about 70-95%.
Radiofrequency ablation is a new step in the treatment of thyroid tumors. This method brings many outstanding advantages over surgery as before: The patient does not need anesthesia, almost no complications, the treatment and recovery time is fast, the risk of recurrence is low (approx. 5%).
This method is indicated for patients with solid tumors, large size, benign, gradually shrinking the size of the tumor by the heat effect caused by the friction of ions in the tissue under the influence of current. high frequency alternating current.
Currently, the technique of high-frequency ablation at Vinmec Times City Hospital is more advanced and superior than other medical facilities. Modern equipment uses the most modern diagnostic imaging today, typically the GE Healthcare S9 ultrasound machine with a flat transducer, high frequency, HD resolution for clear images.
Radiofrequency ablation technique to treat thyroid tumors under ultrasound guidance allows the doctor to control the entire procedure, avoiding maximum damage to blood vessels, nerves, trachea, esophagus, so it is very safe, while reducing the maximum tumor size,... The technique is performed by a team of doctors who have been trained and worked for many years in the endocrinology industry.
The thyroid gland is a large gland with many important functions, the thyroid gland is in an easy to see location and some diseases can be detected with the naked eye. General examination includes regular thyroid exams to detect medical conditions and correct them in time.
Vinmec International General Hospital is one of the leading units in screening and screening to help check thyroid function. The screening and early detection of common thyroid diseases such as simple goiter, hyperthyroidism, hypothyroidism, thyroiditis, thyroid nodules, thyroid cancer, etc. will help doctors have appropriate and timely treatment for the patient.