Abstract
Using ultrasound a thyroid nodule is detectable in more than one half of women in middle age or older. Besides history and physical examination the most important in the diagnostic workout is thyroid ultrasound with guided fine-needle aspiration cytology.
Scintigraphy is indicated in cases with hyperthyroidism only. Laboratory investigation of thyroid function (TSH level) and antithyroid antibodies is important.
Estimation of calcitonin level as tumour marker of medullary carcinoma of the thyroid is indicated for selected cases only. Suppressive therapy with thyroxin can decreases nodule volume in about every sixth patient in expense of low TSH level.
It is considered only in young patients after thyroid autonomy has been ruled out. The majority of cases can be only followed-up; in autonomous nodules therapy with radioiodine is indicated.
Surgery remains the treatment of choice when indicated.