| Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. The American Thyroid Association has published guidelines for the management of thyroid nodules, which were updated in 2015. The major causes of thyroid nodule development include, [[Multinodular goiter|multinodular (sporadic) goiter]], [[Hashimoto's thyroiditis]], [[cysts]], macrofollicular/microfollicular adenomas, childhood [[radioiodine]] exposure, [[familial history]], and [[gene]] [[mutations]]. [[Neck masses]] can be mistaken for thyroid nodules. The most important [[neck masses]] that can be mistaken with thyroid nodules include, [[Thyroglossal cyst|thyroglossal]] duct cyst, [[parathyroid cancer]], [[Parathyroid gland|parathyroid]] cyst, and [[branchial cleft cyst]]. While the diagnosis of a thyroid nodule is established, thyroid nodule should be differentiated based on benign or [[malignant]] features and the type of nodule. Common [[risk factors]] associated with thyroid nodules include, older age, [[iodine deficiency]], previous history of [[iodine deficiency]] and [[hypothyroidism]], living in iodine deficient areas, family history of [[Autoimmune disease|autoimmune diseases,]] multiparity, and [[smoking]]. A solitary thyroid nodule may become [[symptomatic]] if it grows rapidly due to [[hemorrhage]] or [[malignancies]], invades [[Laryngeal nerve|laryngeal nerves]], compressing nearby structures, and secretory nodules that produce [[TSH]]. Thyroid nodules may be a manifestation of [[thyroid cancer]], that usually develops in the 6th decade of life, and start with [[symptoms]] such as [[weight loss]], [[fatigue]], and [[hoarseness]]. Without treatment, the patient with [[benign]] n<nowiki/>odules may remain [[asymptomatic]], while the patients with [[thyroid]] [[neoplasm]] may develop distant [[metastasis]], which may eventually lead to death. The most common complications of thyroid nodules are [[hoarseness]], [[horner's syndrome]], nodule rupture, needle track seeding, [[hemorrhage]]/[[hematoma]], [[dysphagia]], [[upper airway obstruction]], [[pain]], [[skin]] burn, [[Vasovagal Syncope|vasovagal reaction]], [[hypothyroidism]], transient [[thyrotoxicosis]], [[anaphylactic reaction]], [[thromboembolism]], and [[pneumothorax]]. Physical examination should focus on the [[thyroid gland]] and the lateral and central [[neck]] and should assess for [[supraclavicular]] and [[submandibular]] [[adenopathy]]. In case of active hot thyroid nodules that produce [[thyroid hormones]], [[Antithyroid agent|antithyroid drugs]] should be administered, that include [[beta-blockers]], antithyroid drugs ([[methimazole]],[[carbimazole]],[[propylthiouracil]]), [[Iodine-131|radioactive iodine]], and [[thyroidectomy]]. If the nodule excision treatment ([[lobectomy]], [[isthmectomy]], and total [[thyroidectomy]]) is not curative, then treatment with postoperative [[radioactive iodine]] ([[RAI1|RAI]]) remnant ablation and recombinant human TSH–mediated therapy is recommended. Surgical management of thyroid nodule is performed in case of non-diagnostic or suspicious biopsy, for removal of primary [[thyroid cancer]] or for [[thyroid cancer]] staging for [[radioactive]] ablation and [[serum]] [[thyroglobulin]] monitoring. [[Primary prevention]] of thyroid nodule is aimed at prevention of [[thyroid cancer]]. Avoidance of exposure to [[radiation]] and monitoring the population with an increased risk of development of a [[malignant]] thyroid nodule play major roles in [[primary prevention]]. [[Secondary prevention]] of thyroid nodules focuses on [[Prevention (medical)|prevention]] of recurrence of nodules. Different prevention strategies may be used depending upon whether the nodule is [[benign]] or [[malignant]]. In case of a malignant nodule, the major focus is on the [[Prevention (medical)|prevention]] of recurrence after removal of a primary nodule. Post-operative periodic monitoring with [[serum]] [[thyroglobulin]] levels, [[Radioactive iodine uptake|radioactive iodine scanning]], [[neck]] [[ultrasound]] and [[Thyroid-stimulating hormone|thyroid stimulating hormone]] ([[TSH]]) may decrease the chances of recurrence.
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