Benign Thyroid Nodule
Patient’s Problem
A 41-year-old woman, Ms. Tanushri (name changed to protect identity), an accountant, noticed a small lump on the right side of her neck about three weeks ago. She discovered it while applying lotion. The lump had not grown much, was painless, and did not affect swallowing or breathing. She had no hoarseness, weight loss, palpitations, heat or cold intolerance, or fatigue.
Diagnosis
Based on her symptoms, examination, and investigations, the doctor diagnosed a benign thyroid nodule.
Findings included:
Physical Exam:
A 1.8 cm firm, mobile, non-tender nodule was felt on the right thyroid lobe. It moved with swallowing. No cervical lymph nodes were enlarged, and there were no signs of thyroid overactivity or deficiency.
Lab Tests:
Thyroid function was normal.
- TSH: 1.9 mIU/L
- Free T4: 1.1 ng/dL
- Anti-TPO antibodies: Negative
Ultrasound:
Imaging showed a solid, hypoechoic nodule with smooth margins and no microcalcifications. There were no suspicious lymph nodes.
TI-RADS Category: 3 (low suspicion).
FNA Biopsy:
Fine-needle aspiration reported a benign follicular nodule, Bethesda Category II, with no atypical cells.
A general physician in Vadodara explained that the risk of malignancy for Bethesda II nodules is very low and that routine monitoring is the recommended approach.
Treatment
The patient did not require immediate intervention.
Observation:
She was advised to follow a watchful waiting plan with a repeat thyroid ultrasound in 12–18 months. She was guided to report any new symptoms, such as voice changes, difficulty swallowing, or rapid enlargement of the lump.
Symptom-Based Options:
Future treatment options were discussed in case symptoms develop. If the nodule grows or becomes cosmetically concerning, she may consult Women’s General Surgeons for evaluation. Surgery or radioactive iodine would only be considered if the nodule becomes overactive.
Patient Education:
She was counselled on the benign nature of most thyroid nodules, the importance of regular follow-ups, and the avoidance of supplements marketed to shrink thyroid lumps.
Result
At her 12-month follow-up, the nodule showed only minimal growth (from 1.8 cm to 1.9 cm). No new suspicious features were seen, and her thyroid hormone levels remained normal.
Her prognosis is excellent, and she continues routine surveillance with the treating lady doctor in Vadodara, with surgical support available if ever needed.
Note: This case study is for illustrative purposes only and should not replace professional medical advice. If you have concerns about your health, please consult with a qualified healthcare provider.
