Case Challenge| Volume 19, ISSUE 3, 104543, March 2023

A Case Challenge: Differentiating Thyroid Nodules for Malignancy and Management

Published:February 08, 2023DOI:


      • Thyroid nodules are a typical incidental finding.
      • Thyroid nodules should be evaluated through ultrasound for metastatic features.
      • Benign thyroid nodules require routine monitoring for noncancer complications such as dysphagia, dysphonia, or shortness of breath.
      • High-risk thyroid nodules require ultrasound-guided fine-needle aspiration biopsy.


      An increase in the identification of thyroid nodules (TNs) leads to a subsequent increase in benign nodules being misdiagnosed as malignant. The American Thyroid Association has recognized that most TNs are benign and has developed clinical guidelines to guide clinical decision making for the reduction of excessive thyroidectomy. Evaluation and treatment of TNs is recommended for all nodules identified through palpation and incidentally through advanced imaging. The goal of evaluation is to initiate accurate monitoring and management recommendations based on malignancy risk determined by patient history, physical examination, ultrasound imaging, and fine-needle aspiration biopsy when indicated.


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      Cesalie D. Wallace, DNP, FNP-BC, who can be contacted at [email protected], and Margaret Love, DNP, FNP-BC, are nurse practitioners at the University of Arkansas Medical Center, Little Rock.