Incidental Thyroid Nodule: OK, Now What?

Gordon H. Sun, MD, MS


December 13, 2016

Case: Unexpected Thyroid Finding

A 52-year-old man was referred to an orthopedic surgeon with intermittent bilateral upper- and lower-extremity weakness and tingling, along with occasional difficulty walking. The patient underwent MRI of the cervical spine to rule out spinal stenosis. The MRI report incidentally noted two nodules, each about 1 cm, in the right thyroid lobe. No pathologic enlargement of cervical lymph nodes or radiographic evidence of thyroid nodule invasion of local tissues was noted.

Upon learning of the thyroid nodules from the surgeon's referral letter and the radiologist's report, the patient's family physician ordered a follow-up thyroid ultrasound. The ultrasound identified a 0.9 × 0.7 × 0.8 cm hypoechoic solid nodule and 0.7 × 0.6 × 0.4 cm solid/cystic nodule in the right thyroid lobe. No microcalcifications or irregular margins were noted in either nodule.


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