Thyroid incidentalomas: to treat or not to treat

Eur Arch Otorhinolaryngol. 2010 Jul;267(7):1019-26. doi: 10.1007/s00405-010-1207-1. Epub 2010 Feb 13.


Incidental lesions of the thyroid gland are an increasing problem facing clinicians. While asymptomatic palpable lesions are detected in only 4-7% of the population, currently available imaging modalities are sensitive enough to detect lesions in 20-30% of the population. Guidelines for managing these incidentalomas are limited, largely due to lack of well-powered prospective studies. This review will address the currently available data on thyroid incidentalomas, detected through clinical examination, cross-sectional imaging, ultrasound, and PET scans. We will focus on the modalities of detection and risk of malignancy, further investigation and management options and the deficiencies therein. We propose a pragmatic algorithm when faced with this clinical dilemma under differing circumstances.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Decision Making
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Humans
  • Incidental Findings
  • Risk Factors
  • Thyroid Nodule / diagnosis*
  • Thyroid Nodule / therapy*