Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- palpable thyroid nodule
Other diagnostic factors
- early adulthood
- family history of thyroid cancer
- hoarseness
- dyspnoea
- dysphagia
- tracheal deviation
- cervical lymphadenopathy
- rapid neck enlargement
Risk factors
- head and neck irradiation
- female sex
- family history of thyroid cancer
Diagnostic investigations
1st investigations to order
- TSH
- ultrasound, neck
- fine-needle aspiration
Investigations to consider
- molecular analysis of cytology specimens
- free T4
- free T3
- laryngoscopy
- I-123 thyroid scan and uptake
- core biopsy
- CT neck
- serum calcitonin
- genetic testing for familial syndromes
Emerging tests
- translaryngeal ultrasound
- sentinel node biopsy
Treatment algorithm
papillary, follicular, or Hürthle
anaplastic
medullary
primary thyroid lymphoma
Contributors
Authors
Rajiv Datta, MD, FACS, FRCS, FICS
Chairman
Department of Surgery
Professor Of Surgery, Icahn School of Medicine at Mount Sinai
Chief
Division of Surgical Oncology
Chief
Division of Head and Neck Surgery
Mount Sinai South Nassau Hospital
Oceanside
NY
Disclosures
RD declares that he has no competing interests.
Peer reviewers
Rosemarie Metzger, MD, MPH, FACS
Associate Professor of Surgery, Endocrine Surgery Division
Banner - University Medical Center
Phoenix
AZ
Disclosures
RM declares that she has no competing interests.
Lindsay Bischoff, MD
Associate Professor
Medical Director Vanderbilt Thyroid Center
Vanderbilt University Medical Center
Nashville
TN
Disclosures
LB declares that she has no competing interests.
F. Fausto Palazzo, MS, FRCS
Consultant Endocrine Surgeon
Hammersmith & Charing Cross Hospitals
Clinical Lead for Endocrine Surgery
Honorary Senior Lecturer
Imperial College
London
UK
Disclosures
FFP declares that he has no competing interests.
Differentials
- Benign thyroid nodule
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: thyroid carcinoma
- Practice parameter for the performance and interpretation of diagnostic ultrasound of the thyroid and extracranial head and neck
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer