There's a lump in my neck.

• A visible or palpable lump in the front of the neck
• A sensation of pressure or tightness in the throat
• Difficulty swallowing solid food
• Change in voice or hoarseness
• Cough or a feeling of something stuck in the throat
• Breathlessness when lying flat, in large nodules
• Symptoms of an overactive gland — palpitations, weight loss, tremor, heat intolerance
• Symptoms of an underactive gland — fatigue, weight gain, cold intolerance

• Colloid nodules — the commonest, entirely benign overgrowth of normal tissue
• Thyroid cysts, sometimes filling rapidly and causing sudden swelling
• Follicular adenoma, a benign tumour
• Autonomously functioning ('hot') nodule producing excess hormone
• Hashimoto's thyroiditis producing a nodular gland
• Iodine deficiency causing multinodular goitre
• Thyroid cancer, in a small minority of nodules

• Female sex
• Increasing age
• Iodine deficiency
• Family history of thyroid disease
• Previous radiation exposure to the head or neck
• Autoimmune thyroid disease
• Pregnancy, which can enlarge existing nodules

• A nodule that is growing rapidly over weeks
• New, persistent hoarseness
• A hard, fixed lump that does not move on swallowing
• Enlarged lymph nodes in the neck
• Difficulty breathing or swallowing
• Any nodule appearing after childhood radiation exposure

1. 01

   History

   Duration and growth of the lump, pressure symptoms, voice change, radiation exposure and family history of thyroid cancer.

2. 02

   Clinical examination

   Size, consistency and mobility of the nodule, whether it moves on swallowing, and whether neck nodes are enlarged.

3. 03

   Blood tests

   TSH first, with free T4 and T3 where abnormal; thyroid antibodies where autoimmune disease is suspected; calcitonin in selected cases.

4. 04

   Imaging

   High-resolution ultrasound with a standardised risk score, followed by fine-needle aspiration of nodules that meet criteria.

• Observation with surveillance

  Observation

  Appropriate for small benign nodules without symptoms — repeat ultrasound rather than intervention.

• Radiofrequency ablation

  Ablation

  A fine needle electrode is placed into the benign nodule under ultrasound and heat destroys it from within. It shrinks progressively over months while the rest of the gland is untouched.

• Microwave ablation

  Ablation

  The same principle with microwave energy, often faster for larger nodules.

• Ethanol ablation

  Ablation

  Preferred for pure cysts. Fluid is aspirated and alcohol instilled to prevent refilling.

• Thyroid artery embolization

  Endovascular

  Blocking the arteries feeding a very large goitre to reduce its size and vascularity, used in selected cases including as a preparation for other treatment.

• Anti-thyroid medication

  Medication

  Controls hormone excess in a functioning nodule while definitive treatment is planned.

• Surgery

  Surgery

  Remains the treatment for malignant, suspicious or very large obstructive nodules, and involves removing part or all of the gland.

Imaging figures for this condition are being prepared. Case imaging is published only once it is anonymised and verified.

1. 01

   Nothing is ablated until cytology confirms the nodule is benign, usually on two separate samples for solid nodules.

2. 02

   Ultrasound is performed personally at the time of the procedure — the nodule and the danger zones are mapped before the needle is placed.

3. 03

   Treatment is under local anaesthesia, with a hydrodissection barrier of fluid protecting the recurrent laryngeal nerve and oesophagus.

4. 04

   The moving-shot technique treats the nodule in overlapping segments so no viable rim is left behind.

5. 05

   Normal thyroid tissue is deliberately spared, so hormone replacement is usually not required afterwards.

6. 06

   Patients go home the same day with no incision, and are followed with ultrasound at three, six and twelve months.

• Thyroid nodule ablation

  Shrinking a nodule without removing the gland.

  →

1. Same day

   Two hours of observation, then discharge. Mild neck ache and a sensation of fullness are usual.

2. Days 1 to 3

   Simple analgesia if needed. Normal eating and speaking. Return to work usually the next day.

3. Week 1

   Any swelling settles. The nodule may briefly feel firmer before it starts to shrink.

4. Month 1 to 3

   Noticeable size reduction. Pressure symptoms typically improve first.

5. Month 6

   Ultrasound review; volume reduction of roughly half to four-fifths is typical for benign solid nodules.

6. Month 12

   Final assessment of shrinkage and thyroid function. A second session is occasionally offered for very large nodules.

This timeline is educational, not a personal recovery promise. Timing varies with the procedure, condition, other illnesses, and complications. Follow your treating team's discharge instructions.

• Ensure adequate dietary iodine, primarily through iodised salt
• Have any new neck lump examined rather than watched at home
• Attend recommended ultrasound surveillance for known nodules
• Report voice change or swallowing difficulty promptly
• Avoid unnecessary radiation exposure to the neck
• Have thyroid function checked if there is a strong family history

No testimonials are published here yet. Patient accounts will appear only once they are consented and verified — nothing on this page is written on a patient's behalf.

Animated films for this condition are being produced. In the meantime, the procedure pages above set out each step in sequence.

• Carotid artery disease

  The carotid arteries carry oxygen-rich blood to the brain. When narrowing develops, the risk is silent until the day it isn't. Targeted intervention restores the channel and protects the brain downstream.