Thyroid Unit

Assessment and management of thyroid nodules and hormonal disorders

The Thyroid Unit at Publio Cordón Memorial Hospital specialises in the assessment and management of thyroid dysfunction and nodular pathology, where an accurate diagnosis and individualised treatment plan are required.

Its scope of care covers both functional disorders — such as hypothyroidism, hyperthyroidism and autoimmune thyroiditis — and thyroid nodules and multinodular goitre, with the aim of establishing a safe approach, based on scientific evidence and tailored to each patient’s clinical profile.

When should a thyroid nodule or a hormonal abnormality be investigated?

An assessment is indicated in the event of persistent abnormalities in thyroid hormone levels, nodular growth, suspicious ultrasound findings or symptoms of cervical compression.

The Unit enables a precise distinction to be made between benign conditions, lesions requiring structured follow-up, and situations requiring referral to other specialities. Each case is analysed taking into account age, medical history, hormonal profile and specific ultrasound characteristics.

Thyroid problems requiring specialist assessment

Thyroid disorders may present with non-specific symptoms — such as tiredness, weight changes, palpitations or intolerance to cold or heat — or be detected incidentally during imaging studies. Therefore, the assessment must be methodical and based on sound clinical criteria.

The conditions most frequently investigated in the Unit include:

• Clinical and subclinical hypothyroidism.

• Hyperthyroidism and Graves’ disease.

• Benign thyroid nodules.

• Multinodular goitre.

• Autoimmune thyroiditis.

• Nodules with indeterminate cytology.

Each condition is managed with an individualised diagnostic and treatment plan, tailored to the level of risk and the characteristics of the lesion or hormonal dysfunction.

Accurate diagnosis using high-resolution technology

The assessment begins with a specialist consultation during which a detailed analysis is carried out of the patient’s medical history, symptoms, and personal and family history. Thyroid function is comprehensively assessed through specific hormone tests, including TSH, free thyroid hormones and, where indicated, markers of autoimmunity.

In functional disorders — such as hypothyroidism, hyperthyroidism or autoimmune thyroiditis — this assessment enables us to confirm the diagnosis, determine the cause and establish a structured follow-up plan.

In terms of structural assessment, the Unit has high-resolution thyroid ultrasound, which allows for the evaluation of gland size, nodular characteristics and any suspicious findings. Where indicated, fine-needle aspiration (FNA) is performed, followed by cytological analysis.

In cases of indeterminate cytology, molecular analysis of the thyroid nodules is carried out, which helps to reduce diagnostic uncertainty and guide clinical management with greater precision.

This comprehensive approach — both functional and structural — facilitates evidence-based decision-making and avoids unnecessary interventions.

Individualised treatment strategy and minimally invasive techniques

Treatment is determined based on the type of disorder identified and the individual’s clinical profile.

In functional disorders, such as hypothyroidism, hyperthyroidism or autoimmune thyroiditis, a precise pharmacological regimen is established and structured endocrinological follow-up is provided. The aim is to normalise hormone levels, control symptoms and prevent associated complications, adapting the treatment plan to clinical and laboratory progress.

In conditions such as Graves’ disease or persistent hyperthyroidism, various treatment options —long-term medical management, radioiodine therapy or referral for surgery— are considered according to well-defined clinical criteria and following an individualised assessment of risk and personal circumstances.

In the case of thyroid nodules, when surgery is necessary based on established clinical criteria —suspected malignancy, significant compression symptoms or lack of response to other treatments— planning is coordinated with the Endocrine Surgery Unit to ensure a safe and appropriate approach.

Every treatment decision is made following a rigorous assessment of risk, the available scientific evidence and the individual clinical situation, prioritising safety, efficacy and the preservation of function.

Clinical support and personalised follow-up

The Unit ensures structured follow-up based on the diagnosis and level of risk. Regular hormone tests and ultrasound scans are carried out, and the treatment plan is adjusted according to clinical progress.

Time is set aside to explain the significance of the findings, answer any questions and clarify the next steps, particularly in situations that cause uncertainty, such as thyroid nodules or abnormal hormone results.

Ongoing clinical support provides reassurance, therapeutic consistency and a doctor-patient relationship based on clear information and shared decision-making.

This model combines diagnostic precision, therapeutic innovation and rigorous, person-centred care.