{"id":4468,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/thyroidnodules\/"},"modified":"2026-03-30T08:17:06","modified_gmt":"2026-03-30T07:17:06","slug":"thyroidnodules","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/endocrinology\/thyroid\/thyroidnodules\/","title":{"rendered":"Thyroid Goitre, Nodules &amp; Cancer"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Thyroid Nodules<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Thyroid nodules, particularly when solitary and clinically obvious, should be investigated, as they carry a small but significant malignant potential (up to 10%). Please check TFTs and refer to the thyroid nodule clinic. The usual presentation is that of a palpable lump in the neck, which moves on swallowing, and there may be no other symptoms or signs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hyper- or hypo-thyroidism associated with a nodular goitre are&nbsp;<strong>unlikely<\/strong> to be due to thyroid cancer: these patients should be referred to a general endocrine clinic.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em><u>Initiation of other investigations (such as ultrasound scanning or autoantibodies)&nbsp;are unnecessary&nbsp;and may cause delay in making the diagnosis of cancer \u2013 further tests will be arranged in the clinic. <\/u><\/em><\/strong><strong><em><u><\/u><\/em><\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Thyroid Cancer<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Should be considered with the finding of a thyroid nodule, especially when solitary &amp; clinically obvious and \/ or rapidly increasing in size.<\/li>\n\n\n\n<li><strong>Is rare, <\/strong>representing only about 1% of all cancers \u2013 around 320 p.a. in Scotland<\/li>\n\n\n\n<li>Can occur at any age and is more common in females<\/li>\n\n\n\n<li>Commoner with family history of endocrine tumours<\/li>\n\n\n\n<li>Is commoner in those with a history of neck irradiation<\/li>\n\n\n\n<li>Has an overall 10-year survival rate for differentiated thyroid carcinoma of 80 &#8211; 90%.<\/li>\n\n\n\n<li>Patients develop local or regional recurrences in 5-20% and 10 &#8211; 15% develop distant metastases.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Please see the <a href=\"https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/advice-and-guidance\/2025\/08\/scottish-referral-guidelines-suspected-cancer-2025\/documents\/scottish-referral-guidelines-suspected-cancer-2025\/scottish-referral-guidelines-suspected-cancer-2025\/govscot%3Adocument\/scottish-referral-guidelines-suspected-cancer-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Cancer Referral Guidelines<\/a> for further detail and USC indications below.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.M &#8211; 27-03-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"has-alert-red-color has-text-color has-link-color wp-elements-e306f0deb338f45fc54b43b4d7cfb1bb wp-block-paragraph\"><strong>Immediate (same day) referrals:&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"has-alert-red-color has-text-color wp-block-paragraph\">Patients with stridor associated with a thyroid swelling should be referred as a same day emergency.<\/p>\n\n\n\n<p class=\"has-alert-red-color has-text-color wp-block-paragraph\"><strong>Urgent referrals for suspected cancer<\/strong>:<\/p>\n\n\n\n<p class=\"has-alert-red-color has-text-color wp-block-paragraph\">Refer a person with a thyroid nodule, and one or more of the following features to the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/entadult\/necklump\/\" target=\"_blank\" rel=\"noreferrer noopener\">Neck Lump clinic<\/a> as USC:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-alert-red-color has-text-color\">A nodule rapidly increasing in size<\/li>\n\n\n\n<li class=\"has-alert-red-color has-text-color\">Associated unexplained hoarseness<\/li>\n\n\n\n<li class=\"has-alert-red-color has-text-color\">Associated cervical lymphadenopathy<\/li>\n\n\n\n<li class=\"has-alert-red-color has-text-color\">Previous neck irradiation<\/li>\n\n\n\n<li class=\"has-alert-red-color has-text-color\">Family history of endocrine tumours<\/li>\n\n\n\n<li class=\"has-alert-red-color has-text-color\">Anyone aged 16 years or under.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline\">Please refer to the Thyroid Nodule Clinic:<\/span><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Euthyroid patients with a goitre.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with thyroid lumps including:\n<ul class=\"wp-block-list\">\n<li>Those with a thyroid lump that has newly presented or has been increasing in size over time.<\/li>\n\n\n\n<li>Those with a history of sudden onset of pain in a thyroid lump (likely to have bled into a benign thyroid cyst)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Thyroid Nodules Thyroid nodules, particularly when solitary and clinically obvious, should be investigated, as they carry a small but significant malignant potential (up to 10%). Please check TFTs and refer to the thyroid nodule clinic. The usual presentation is that of a palpable lump in the neck, which moves on swallowing, and there may be<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4467,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[133],"class_list":["post-4468","page","type-page","status-publish","hentry","category-thyroid-nodules"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/endocrinology\/thyroid\/thyroid-nodules\/\" rel=\"tag\">Thyroid Nodules<\/a>","rttpg_excerpt":"Thyroid Nodules Thyroid nodules, particularly when solitary and clinically obvious, should be investigated, as they carry a small but significant malignant potential (up to 10%). Please check TFTs and refer to the thyroid nodule clinic. The usual presentation is that of a palpable lump in the neck, which moves on swallowing, and there may be","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4468","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4468"}],"version-history":[{"count":10,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4468\/revisions"}],"predecessor-version":[{"id":27429,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4468\/revisions\/27429"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4467"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4468"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4468"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}