Lumps In The Neck: When To Worry And Consult A

Lumps in the neck: when to worry and consult a doctor

The vast majority of thyroid nodules are harmless, but others require diagnosis and treatment in a specialized unit.

Dr. Manuel Gargallo examines the neck of a patient at the Fundación Jiménez Díaz University Hospital.

Feeling your neck when doing a regular activity, such as washing or dressing, and finding solid lumps to the touch can be a distressing experience for many. What are they, and how can they affect health? The concern is natural, since it is a delicate area on which basic functions such as speaking and nourishment depend, not to mention the most pressing, breathing.

The truth is that the appearance of lumps is relatively frequent, especially with age, and can respond to various causes, many of which are benign. It can be about cysts, just as they appear under the skin in other parts of the body, or respond to swollen glands that is symptomatic of an infection to be treated at a general level.

If we notice them at the base of the neck, that is, in the thyroid area, it may be try thyroid nodules, solid or liquid filled. “SThey are very common in the general population. Fortunately, the vast majority of cases are benign and do not require any type of treatment or surgery. Normally they are discovered by chance, when doing some exploration or radiological type test”, explains the Dr Manuel Gargallo, specialist of the Endocrinology and Nutrition Service of the Fundación Jiménez Díaz, and coordinator of the Thyroid Nodule Unit.

Some of these nodules, without posing a risk at first, can grow large enough to become visible or make breathing and/or swallowing difficult. To determine it, the specialist must perform a study to confirm this benignity and rule out the possibility of thyroid cancer. In the case of the surgical approach to remove it, the process can be prolonged with numerous consultations and tests. The wait, Dr. Gargallo values, entails “uncertainty, concern and anguish” for the patient until their final diagnosis is known.

For this reason, the Unit that coordinates in the Madrid center is “made up of professionals especially dedicated to this pathology and with great experience in its management, who offer integrated and high-resolution assistance”. In this way, ” allows patients can be referred directly from Primary Care, without the need for any intermediate consultation or previous exploration or ultrasound“, Says the specialist.

Comprehensive assessment

“In the consultation of this unit, an expert in nodular pathology performs comprehensive assessment of the patient’s nodule, which includes not only the history and clinical examination, but also a complete thyroid ultrasound“, explains Gargallo. At the end of the consultation, and with all the data collected by the same specialist, you will have a “global vision” that allows you to offer a diagnosis to the patient and guide the therapeutic approach to follow until discharge.

Thus, he adds, it can be confirmed “if we are facing an absolutely benign nodule without any type of risk, therefore discharging the patient; if, on the contrary, it is advisable to make a successive assessment, in which case a subsequent review is cited in the unit consultation; or even if indicated a puncture aspiration for some suspicious data, then scheduling for its performance, also within the same unit, a few days later“.

In less than a week the patient has the results of the puncture. If these are benign, you are scheduled for ultrasound checkups; while, if they show any suspicious data, they are referred directly to the Surgery Service for their intervention.

Qualified team and high technology

The Thyroid Nodule Unit of the Jiménez Díaz Foundation highlights the efficiency and agility in the approach to nodular pathology that is achieved with the qualification of the medical team, of great recognition and national projection, coordinated by Dr. Gargallo. But also with the high-tech equipment with which it is equipped, among which a State-of-the-art ultrasound system with a multi-frequency linear array probe (6-15 mHz) with a 50mm viewing width.

“With this ultrasound machine, shear wave elastography (SWE) can be performed on thyroid nodules, which allows us to determine the stiffness of the nodule, both with quantitative measurements and with a 2D color-coded elastogram“, points out the coordinator of the unit, emphasizing that “this new technology helps to establish the benignity or malignity of the nodule”.

This work dynamic has made it possible for patients, with a maximum of two face-to-face consultations, have a complete evaluation of their thyroid nodules and any problems related to them, as well as the treatment or therapeutic approach to follow. All this within the same unit and being cared for by a single specialist who cares for you from the beginning of the process until discharge. “Not only do we achieve high-quality assistance, but also agility, within a concept of care efficiency,” he concludes. Gargallo.