Benign thyroid tumors can hide malignant tumors and need regular examination for early detection

Malignant thyroid tumors are hidden next to benign tumors

Ho Chi Minh City Ms. Nhu, 45 years old, had a benign tumor in her thyroid for 6 years. Now the doctor discovered a malignant tumor hidden right next to her.

When first discovered, the thyroid tumor was benign, so Ms. Nhu did not have regular check-ups. Recently, she had an ultrasound examination and noted that next to the benign tumor, there was a tumor about 1 cm in size, with unclear margins, located close to the capsule, suspected of microcalcification. The results of fine needle aspiration cytology confirmed malignant tumor.

MSc.BS.CKII Pham Tuan Manh, Department of Surgical Oncology, Oncology Center, Tam Anh General Hospital, Ho Chi Minh City, advised Ms. Nhu on thyroidectomy surgery.

Ultrasound results did not show any suspected metastatic lymph nodes. During surgery, the team continues to evaluate and treat the situation depending on the situation. If they detect central cervical lymph nodes suspected of metastasizing or the tumor invades beyond the thyroid capsule, the entire thyroid gland will be removed.

During the surgery, the team separated the recurrent laryngeal nerve, used an ultrasound knife to cut the thyroid gland, and preserved the parathyroid glands. Dr. Manh examined the neck lymph nodes, confirmed there were no signs of metastasis, and the team finished the surgery.

After surgery, Ms. Nhu did not have a hoarse voice and ate, drank, and spoke normally. The wound was dry, painless, and discharged from the hospital after 12 hours of monitoring and health assessment was stable. Patients need to take radioactive iodine to destroy microscopic malignant cells (invisible to the naked eye and microscope) to prevent cancer from metastasizing to neck lymph nodes, other organs (bones, liver, lungs...). After that, she needs to take thyroid hormone to compensate for the missing hormone. Thyroid-stimulating hormone (TSH) inhibition is also an endocrine therapy in the treatment of thyroid cancer to prevent recurrence and metastasis.

Dr. Manh said thyroid tumors are one of the common endocrine disorders. Of these, about 90% of thyroid tumors are benign. Many people believe that benign tumors in the thyroid gland will not change, surgery is only needed when the tumor is large, so they should be subjective and not re-examine. In fact, benign thyroid tumors rarely turn malignant, but patients still need regular check-ups. During cell regeneration, mutations can occur, forming cancer next to or hidden in benign tumors, making it difficult to detect. Thyroid cancer often progresses slowly and has a good prognosis; If detected early, without metastasis, the 5-year survival rate can reach 99%. However, late treatment can cause the disease to metastasize, last longer and become more complicated.

It is currently unknown what causes thyroid cancer. Some factors can increase the risk of the disease such as women 25-65 years old, people exposed to radiation, family history, especially medullary thyroid cancer.

Doctors advise patients with thyroid tumors, especially multiple nodules, to have regular examinations to detect abnormalities and promptly treat them.

When difficulty swallowing, hoarseness, difficulty breathing, neck pain or palpable neck lymph nodes, the patient should see a doctor early. Depending on the condition, the doctor may prescribe monitoring, periodic thyroid ultrasound every 6-12 months, thyroid function tests or biopsy when necessary.

Khai Minh

*Patient's name has been changed