T3, T4, Tsh normal but ultra sound report 31x21mm sized heterogenous hyperechoic lesion is operation needed?

Answer 1

Usually the lesions need to be tested if, their hot or cold & if they're interfering with swallowing or breathing...
Besides getting a 2nd opinion, I would avoid fluoride in your water & especially your tooth paste. Fluoride interferes with Thyroid function as well as coniferous vegetables...
If you eat them, make sure they're not raw.

Answer 2

I would recommend consulting an endocrinologist (a doctor that diagnoses and treats diseases and disorders that involve hormones such as with the thyroid) for another opinion if you haven't already to see what they suggest.