Evaluation and management of the solitary thyroid nodule

Thyroid nodular disease is very common in the United States, with palpable nodules occurring in approximately 5% of adults, especially in women. Because of the possibility of a single nodule being cancerous (albeit only approximately 5%), a thorough clinical evaluation, including a detailed history and physical exam, must be undertaken. Fine needle aspiration biopsy is the cornerstone of the laboratory evaluation of thyroid nodules, and its use in recent years has resulted in a significant decrease in the number of thyroid surgeries being performed, while increasing the yield of malignant lesions of patients who have undergone operation. The utility of levothyroxine suppression in patients with benign thyroid nodules continues to be controversial.