Consultant Head and Neck, Thyroid Surgeon

Thyroid Swellings and Nodules

A swelling in the neck due to an enlarged thyroid gland is called a goitre. Nodules are lumps in the thyroid gland. Most are harmless but you should arrange an appointment with your doctor as soon as you find a lump or swelling.

Main causes of enlargement of the thyroid

The main cause is unknown but thyroid nodules and enlargement are more common in women than men
Women often develop thyroid enlargement during pregnancy and the menopause
Diffuse enlargement is often caused by autoimmune thyroid conditions such as Hashimoto's thyroiditis and Graves' disease and can be associated with a change in thyroid function
Iodine deficiency is the most common cause worldwide

Main types of thyroid nodules and swellings

Single thyroid nodule (solitary nodule)
Multiple thyroid nodules (multinodular goitre) - sometimes caused by an over-active thyroid
Diffuse goitre - often found in Hashimoto’s thyroiditis and Graves’ disease (autoimmune thyroid disorders)
Retrosternal goitre - thyroid develops lower down behind the breastbone (often a multi-nodular goitre)
More about single nodules
Colloid and hyperplastic nodules – benign lumps, which can be solitary or part of a multinodular goitre
Thyroid adenoma - a solid benign lump
Thyroid cyst - swelling that contains fluid
Thyroid cancer - rare and has a high cure rate


Some of the following investigations may be necessary:

Blood tests - check thyroid hormone levels
Ultrasound scan - checks size and shape of thyroid
Fine needle aspiration cytology (FNAC) - removes cells from the thyroid for examination
X-rays - to check position of windpipe (trachea)
Nuclear medicine scan - checks size, shape and whether over-active (‘hot’) or under-active (‘cold’)
This may involve one or several of the following:

Usually reassurance is only required
Radioactive iodine
Antithyroid drugs
Levothyroxine tablets
It is well recognised that thyroid problems often run in families and if family members are unwell they should be encouraged to discuss with their own GP whether thyroid testing is warranted.