History

• Symptomatic/ asymptomatic
  • features of hyper/ hypo-thyroidism
• Mechanical pressure
  • dyspnoea, dysphagia

• Hoarseness
• Pain, rapid increase in size: secondary deposit from renal, breast or lung carcinoma
• Cosmetic problems 
• Past History:
  • surgery, irradiation
• Family history of thyroid carcinoma 

Examination 

Thyroid status: 

• Eu/hypo/hyper-thyroidism

Neck: 

Diffuse / MNG / Solitary Nodule

• Moves with swallowing→ thyroid swelling
• moves with tongue protrusion → thyroglossal cyst 
• Size
• Intra-thoracic extension
• Consistency: Firm/Hard/Cystic
• Mobile/Fixed
• Tenderness

Lymph node 

• Cervical lymphadenopathy increases the likelihood of malignancy

Ivestigatio:

Treatment:

Benign nodules (70%)

• Euthyroid

• • No pressure symptoms
  • Cosmetically acceptable 
  • Yearly follow up: Clinical, Biochemical, USG 
  • Pressure + Cosmetic Problem: Limited Surgery

• Toxic Nodule: 

• Medical (CMZ/PTU + Propranolol)

                                         ↓

                           Followed by surgery     

Malignant Nodule (s)

• Surgery