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Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 150-153

Thyroid nodule location and the risk of thyroid cancer: What do we know?

1 Department of Internal Medicine, Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, Saint Louis, MO, USA
2 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Correspondence Address:
Dr. Hossein Gharib
Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic College of Medicine, Rochester, MN, 200 First Street SW, Rochester, Minnesota 55905
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdep.jdep_51_21

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Thyroid nodules are common in clinical practice and are routinely evaluated with neck ultrasound. Multiple guidelines rely on sonographic features to assist physicians when deciding if nodules require observation or fine-needle aspiration (FNA). Existing classification systems for risk stratification of thyroid nodules are different but equally accurate. The purpose of this article is to review the significance of thyroid nodule location as an important factor in assessing the risk of malignancy. Several topical issues are addressed. (1) Thyroid nodule location and risk of differentiated thyroid cancer, (2) Thyroid nodule location and risk of nodal metastasis, (3) Thyroid nodule location and surgical approach, (4) Thyroid nodule location and stratifications systems (5) Conclusions and future direction. In conclusion, it is advisable not to reply solely on ultrasound-derived risk levels when evaluating thyroid nodules to determine optimal management including nodule FNA, follow-up or no additional intervention. This is likely because other clinically important features might not be accounted for when using those risk stratification algorithms. There are now reasonable data to suggest thyroid nodule location may be an additional prognostic predictor. In the lack of clear radiologic guidance, clinical judgment remains the main driving factor.

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