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Hoarse voice, dominant thyroid nodule, hetergeneity of entire gland (mu...
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Hoarse voice, dominant thyroid nodule, hetergeneity of entire gland (multinodular goiter) - what does this mean?

I am in my late 50's. I just was referred to a surgeon as a result of an ultrasound which showed dominant 1.5 cm nodule left lobe at the isthmus. Scan also showed diffuse heterogeneity of the entire gland (multinodular goiter).  Gland is of normal size.  

All ths started when I had a lung CT and thyroid nodules were detected.  The lung CT also showed spot 6 X 5 mm upper left lobe (following up in six months on that).  

I have also been getting progressively more hoarse over the last six months.  It gets worse as the day goes on.

I know odds are rare that this is a major issue but why the surgeon?  Also, I am really bugged by the hoarseness.  Could the location of this small nodule have anything to do with the hoarseness?  I noticed that there is a nerve near the location of the nodule.  Just curious.  

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You likely need a biopsy (FNA) of the left 1.5cm nodule -- 90-95% of these are benign.  The ENT can look at the vocal cords and help determine if the hoarseness may be related to the nodule -- likely it's not, but worth looking into given the increasing hoarseness.  Thyroid masses cause hoarseness by pressing on the recurrent laryngeal nerve which goes to the vocal cords and runs behind the thyroid.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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