Patient presents with anterior neck mass

 Palpable nodule discovered by patient or

physician
OR
 Incidental nodule discovered on imaging, not
clinically palpable.

Gather history, perform examinations

 TSH measurement
 Ultrasonography
 Other labs

Low TSH TSH normal or high

Perform radiolnuclide thyroid scan

Solitary solid nodule Multiple nodules Apparent palpable nodule not
demonstrated on imaging

Consider radioiodine ablation or surgical

excision if hyperfunctioning ≥ 4 cm > 1 cm or ≤1 cm with > 1 cm ≤1 cm Clinical follow-up
risk factors

Clinical follow-up
Diagnostic lobectomy

UTZ-guided fine-
needle aspiration

Malignant or suspicious of malignancy Benign Unsatisfactory specimen

Thyroid surgery Follow-up in 6 months (earlier if Repeat FNA after 1-4 weeks to mirror
symptomatic) structure of other end points