From the Guidelines
A 1.5cm thyroid nodule may cause a variety of symptoms, including a visible lump in the neck, difficulty swallowing, sensation of a lump in the throat, neck discomfort or pain, voice changes or hoarseness, and rarely, breathing difficulties, and should be evaluated by a healthcare provider to rule out malignancy and assess thyroid function.
Symptoms and Evaluation
The symptoms experienced by a patient with a 1.5cm thyroid nodule can vary depending on the nodule's location and characteristics. Some possible symptoms include:
- A visible lump in the neck
- Difficulty swallowing (dysphagia)
- Sensation of a lump in the throat
- Neck discomfort or pain
- Voice changes or hoarseness
- Rarely, breathing difficulties if the nodule compresses the trachea If the nodule is producing excess thyroid hormones (a "hot" nodule), symptoms of hyperthyroidism might occur, including anxiety, weight loss, tremors, heart palpitations, increased sweating, and heat intolerance 1. Conversely, if the nodule affects overall thyroid function by causing hypothyroidism, symptoms could include fatigue, weight gain, cold intolerance, dry skin, and constipation.
Diagnostic Approach
The size of 1.5cm is significant enough to warrant evaluation by a healthcare provider, typically through blood tests to assess thyroid function, ultrasound imaging, and possibly fine needle aspiration biopsy to rule out malignancy, as nodules larger than 1cm generally require further investigation 1. The American College of Radiology (ACR) has published guidelines for the management of thyroid nodules, including the use of ultrasound imaging and fine needle aspiration biopsy 1.
Management
The management of a 1.5cm thyroid nodule will depend on the results of the diagnostic evaluation. If the nodule is found to be malignant, treatment may include surgery, radioiodine ablation, or other therapies. If the nodule is benign, treatment may not be necessary, but ongoing monitoring may be recommended to ensure that the nodule does not grow or change over time.
From the Research
Symptoms of a 1.5cm Thyroid Nodule
The provided studies do not directly address the symptoms caused by a 1.5cm thyroid nodule. However, they discuss the evaluation and diagnosis of thyroid nodules in general.
Evaluation and Diagnosis
- Fine-needle aspiration biopsy (FNA) is the standard test to determine whether surgical removal of a detected nodule is recommended 2, 3, 4, 5, 6.
- FNA has an essential role in the evaluation of patients with thyroid nodules to reduce the rate of unnecessary thyroid surgery for patients with benign nodules and triage patients with thyroid cancer to appropriate surgery 2.
- The procedure is safe, reliable, and rapid, and its effectiveness is highly dependent on the expertise of the operator performing the procedure and the adequacy of the specimen for interpretation of the cytomorphologic features 4, 5.
Thyroid Nodule Prevalence
- Thyroid nodules are a common clinical problem, with an estimated prevalence ranging from 5%-10% of adults in the United States 2, and up to 67% of people screened by sonography in older adults 2.
- Most thyroid nodules are benign, but 5% are likely to be malignant 3.