Thyroid nodule history and symptoms

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History and Symptoms

History

Obtaining a detailed history is one of the important aspects of determining the best approach toward nodule management. It provides insight into possible cause, precipitating factors and associated comorbid conditions. Complete history may also helps in determining the prognosis. Specific histories about associated symptoms and their duration, onset, and progression have to be obtained. Specific areas of focus when obtaining the history, are outlined below:

  • The presence of associated symptoms
  • A change in nodule size
  • Previous head or neck radiation exposure
    • Childhood irradiation associated with high risk of malignancy
  • Family history
    • Thyroid diseases
    • Thyroid cancer syndromes
    • Endocrine diseases (e.g. multiple endocrine neoplasia type 2 [MEN2], familial adenomatous polyposis, or Cowden syndrome)
  • History of neck pain
  • Sudden increase in the size of a neck lump
    • Raise the concern of malignancies and hemorrhagic thyroid cysts
  • Progressive voice change or hoarseness
    • May be associated with an invasive tumor

Symptoms

  • Dysphagia or anterior neck discomfort
    • May indicate a malignant tumor
    • Rarely seen in benign tumors
    • Choking sensation
    • Inability to lie flat
  • Hoarseness
  • Localized pain in the neck
  • Shortness of breath
  • Prolonged cough
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