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Clinical Practice
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Volume 351:1764-1771 October 21, 2004 Number 17
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The Thyroid Nodule
Laszlo Hegedüs, M.D.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 42-year-old woman presents with a palpable mass on the left side of her neck. She has no neck pain and no symptoms of thyroid dysfunction. Physical examination reveals a solitary, mobile thyroid nodule, 2 cm by 3 cm, without lymphadenopathy. The patient has no family history of thyroid disease and no history of external irradiation. Which investigations should be performed? Assuming . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

History and Physical Examination

Laboratory Investigations

Imaging of the Thyroid Nodule

            Radionuclide Scanning

            Ultrasonography

            Other Methods

Fine-Needle Aspiration Biopsy

Treatment of the Solitary Thyroid Nodule

            Levothyroxine

            Surgery

            Radioiodine

            Percutaneous Ethanol Injection

Areas of Uncertainty

Guidelines from Professional Societies

Conclusions and Recommendations


Source Information

From the Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.

N Eng J Med 2004;351:1764-71.

Address reprint requests to Dr. Hegedüs at the Department of Endocrinology and Metabolism, Odense University Hospital, DK-5000 Odense, Denmark, or at laszlo.hegedus@ouh.fyns-amt.dk.


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