Solitary Thyroid Nodule Guidelines

Updated: Jul 15, 2022
  • Author: Andre Hebra, MD; Chief Editor: Robert P Hoffman, MD  more...
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Guidelines Summary

The American Thyroid Association (ATA) issued management guidelines for children with thyroid nodules and differentiated thyroid cancer.  The guidelines included some of the following recommendations [16, 17] :

  • For children at high risk for thyroid neoplasia, an annual physical examination is recommended and if the examination finds palpable nodules, thyroid asymmetry, and/or abnormal cervical lymphadenopathy, additional imaging is warranted.

  • Instead of size alone, ultrasound characteristics and clinical context should be used to identify nodules that merit fine-needle aspiration which should be implemented using ultrasound guidance.

  • Lobectomy may be done in patients with compressive symptoms and cosmetic concerns or if the patient or parent prefers. Consider lobectomy in all benign appearing solid thyroid nodules >4 cm, the lesions that have grown significantly, or if malignancy is a concern.

  • The indications for 131I treatment are unresectable iodine-avid persistent locoregional or nodal disease and also for identified or assumed iodine-avid distant metastases.