[The cold thyroid nodule]

A "cold" thyroid nodule basically always carries the risk of being "malignant". Scintigraphy and sonography can not differentiate between benign and malignant. The best means to discriminate the risk of "cold nodules" is by way of fine needle aspiration biopsy. In general the operative indication for "cold" nodules can be generous. In high suspicion the best surgical strategy is "hemithyroidectomy" as primary operation.