Article Sections

Introduction

Thyroid nodules are common and can have clinical significance due to possible metabolic overactivity (ie, thyrotoxic nodules) or malignant potential.  They can be categorized conceptually as follows:

  • benign versus malignant
  • metabolically active (solitary toxic adenoma, toxic multinodular goiter) versus non–metabolically active

These considerations are interrelated as metabolically active nodules are rarely malignant, whereas non–metabolically active nodules have a much greater risk for malignancy.  The specific types of thyroid cancer are described in a separate article.

Clinical presentation

Thyroid nodules may be reported by the patient due to a visible abnormality in the thyroid or due to effects on nearby structures (eg, vocal hoarseness).  In clinical practice, nodules may be noted on physical examination or as an incidental finding on radiology studies (eg, MRI of cervical spine).  Toxic nodules may also be detected during evaluation of hyperthyroidism.

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