Does an increase in thyroid nodule size indicate malignancy?

Hi,

Welcome to icliniq.com.

Thank you for writing and I understand your concern.

The nodule is hypoechoic, but there is no mention of other features like echogenic deposits, height>width, or irregular borders, which are essential to categorize it as TIRADS IV.

However, I recommend obtaining a reevaluation by the radiologist to update the TIRADS (Thyroid Imaging Reporting and Data Systems) score, especially since they mentioned a benign or adenomatous etiology. If the images are available, I can also review them for further assessment.

Regarding the size increase, there is a slight difference between the previous measurement from last year (0.88) and the recent one (1.09), possibly due to the placement of calipers during measurement. Nevertheless, it is essential to consider the size increase, and if it continues to grow, a fine-needle aspiration cytology (FNAC) should be performed.

As of now, my opinion remains that it is still the same nodule (low risk for malignancy) with probable slight growth. I suggest following up with a repeat ultrasound in 6 to 12 months to monitor any further changes.

Feel free to reach out for further queries or clarifications.

Thank you.

Hello,

Welcome back to icliniq.com.

Yes, it is mentioned in the report that there are no calcifications, which is a positive finding. Regarding the halo, it does not hold significant clinical value in this context.

Upon reviewing the images (attachements removed to protect the patient’s identity), it is evident that the dominant right nodule is very hypoechoic, has defined borders, and is located very close to the thyroid capsule. Considering these features, the ATA (American Thyroid Association) risk score classifies it as an intermediate-risk nodule, and the recommendation is now to proceed with fine-needle aspiration cytology (FNAC) since the size is more than 1 cm in its largest dimension.

I have revised my opinion based on the personal review of the images provided, with the understanding that real-time viewing was not possible. The decision for FNAC is made based on both the ATA risk score and individual judgment considering its proximity to the thyroid capsule. While TIRADS IV nodules can be followed without FNAC if they are less than 1 cm in size, in this case, the size of the nodule exceeds 1 cm, warranting further evaluation through FNAC.

I hope this information helps you.

Feel free to ask further queries.

Thank you.

Hi,

Welcome back to icliniq.com.

Yes, since malignancy is highly probable in TIRADS 3. I would suggest you get a FNAC done.

Thank you.