Thyroid nodules: early diagnosis and treatment, the role of alcoholisation
Thyroid nodules are an increasingly common condition in the general population and, in most cases, are discovered occasionally during routine check-ups or examinations performed for other reasons. Although they are often benign formations, their presence requires proper clinical investigation to rule out any risks and identify the most appropriate strategy.
When is it really necessary to intervene? What are the signs that should not be underestimated? And above all, what are the alternatives to traditional surgery today? We ask prof. Alessandro Marugo, endocrinologist and head of the Thyroid Centre at IRCCS Policlinico San Donato, who explains how medical advances are significantly changing the approach to these pathologies.
"The thyroid is a small but fundamental gland: it regulates metabolism, heartbeat, body temperature and numerous vital processes. That is why it is important not to underestimate any alterations,' explains Marugo.
Thyroid nodules: when to worry
In most cases, nodules do not give symptoms and are simply monitored over time. However, a specialist evaluation is essential to identify situations that require further investigation.
"Thyroid nodules can remain silent for years, but an early diagnosis allows, above all, to avoid unnecessary interventions and to direct the patient to the most appropriate course of action," Marugo emphasises.
Signs that should not be overlooked include swelling in the front of the neck, difficulty swallowing or unexplained weight changes.
Diagnosis and clinical management
The diagnostic pathway is based on simple but extremely effective tools: endocrinological examination, thyroid ultrasound and possibly needle aspiration, which allows the nature of the nodule to be analysed.
"Each case is assessed in an integrated manner, bringing together different skills to arrive at a precise diagnosis and a targeted therapeutic choice," explains Marugo.
The multidisciplinary work allows us to define more accurately when follow-up is sufficient and when, on the other hand, it is appropriate to intervene.
Alcoholisation: a valid alternative to surgery
Alongside traditional surgery, increasingly effective non-surgical procedures have become established in recent years. Among these, thyroid nodule alcoholisation is a well-established solution for specific types of benign nodules.
"Alcoholisation is an outpatient procedure that consists of injecting ethanol into the nodule, causing it to progressively shrink until it heals," explains Marugo.
Especially indicated for cystic or mixed nodules, i.e. those with a liquid component, this technique is performed under ultrasound guidance and does not require general anaesthesia or hospitalisation. After a brief observation, the patient can return to his or her daily activities.
"It is a safe and quick treatment, which provides real benefits both clinically and aesthetically, with virtually immediate recovery," he adds.
Over time, the effect of ethanol leads to a significant reduction in the volume of the nodule, until it almost completely heals, helping to alleviate any compression symptoms or local discomfort.
When it is necessary to intervene
The decision to treat a nodule depends on several factors: size, ultrasound characteristics and the presence of symptoms. If the nodule grows, causes compression or creates aesthetic discomfort, it is possible to resort to targeted treatments.
"Today we have several therapeutic options available: the choice is calibrated on the individual patient, favouring when possible effective but less invasive solutions," stresses Marugo.
In this context, alcoholisation is one of the most useful strategies for reducing the need for surgery in selected cases.
The value of prevention
Prevention also plays a central role in thyroid diseases.
"Checking the thyroid gland is a simple but fundamental gesture. If there is a family history or suspicious symptoms, it is important to see a specialist without delay," concludes Marugo.
The Thyroid Centre at Policlinico San Donato is a reference point precisely for this integrated approach, which combines accurate diagnosis, advanced technologies and constant follow-up over time.
Towards increasingly targeted medicine
Medical advances are changing the way thyroid nodules are dealt with, making it possible to take an increasingly precise approach that is tailored to the patient's real needs.
"The goal is not just to cure, but to choose when and how to intervene, minimising the impact of treatment and improving quality of life. It is in this direction,' he concludes, 'that endocrinology is moving today: a medicine capable of being both effective, sustainable and increasingly tailor-made.
