Thyroid surgery or not?

[hazelhurst]

I have a multinodular goiter, with the largest nodule on the right lobe, now measuring 2.7 by 2.7 by 3.1 cm. Nine months ago this nodule measured 2.1 by 2.8 by 2.3 cm. I have normal TSH and negative thyroid antibodies. The biopsy last August was benign. My inclination is to go ahead with the surgery, and my doctors are pointing me in this direction, since the large nodule is getting larger. But, I am in good health and 42 years old. Should I wait until the nodule is even larger, or possibly suspicious? Or should I just nip this in the bud?

[hazelhurst]

Many thanks! I am carefully considering the options.

[Mark Lupo, M.D.]

Repeat the FNA.  If this is still benign and you have no compressive symptoms I would watch it unless it continues to grow -- then do the surgery.  Surgery however is the only way to 100% exclude a malignancy hiding in the multinodular thyroid.  If you have surgery and have bilateral nodules it may be worth considering a total thyroidectomy.

Have you tried levothyroxine to suppress the growth of the goiter?  May be worth a try.

In summary, reasons for surgery would be peace of mind (balanced against risks of surgery), compressive symptoms, or suspicious biopsy.