Prediction of malignancy in solitary thyroid nodules: value of preoperative explorations

The thyroid nodule is a topic in clinical medicine which remains controversial because any thyroid disease can virtually turn up a thyroid nodule. The reliability of the diagnostic techniques for making the distinction between a benign and a malignant lesion varies. The various techniques for the assessment of a solitary nonfunctional thyroid nodule are described and their comparative values in establishing the nature of the nodule, identifying patients with low likelihood of malignancy--making it possible to defer surgery or to avoid it altogether--are analyzed. According to the results and for several reasons, controversy over the best approach of solitary cold nodule management can remain. We propose an alternative approach and provide a personal guideline for the use of these tests.