Current Guidelines for the Management of Thyroid Nodules

Robert A. Levine, MD, FACE, ECNU


Endocr Pract. 2012;18(4):596-599. 

In This Article


The 3 current sets of guidelines provide excellent guidance regarding the management of thyroid nodules. As previously stated, this brief commentary addresses only a minute fraction of the comprehensive knowledge base presented in the complete guidelines.[1–3] The ATA is currently planning to issue revised guidelines in 2013. They have been actively seeking input regarding areas of agreement and disagreement with the current guidelines. It is my hope that the revised version will add a discussion of the effect of mitigating factors such as age, comorbidities, and life expectancy on the decision to perform a biopsy. Many elderly or chronically ill patients may be better served by careful observation than intervention, and updated guidelines should provide direction in this decision process. Following the lead of the KSTR guidelines, a more comprehensive set of recommendations regarding risk stratification of complex cysts would be welcomed. Similarly, the guidelines should discuss whether more low-risk thyroid nodules can be safely monitored with serial ultrasonography, considering the risk of missing a low-grade thyroid cancer versus the risks associated with a surgical procedure for malignant or benign thyroid disease.