Thyroid nodular disease

Due to the development and increasing accessibility of modern imaging techniques, thyroid nodules have become a very frequently diagnosed pathology. They are clinically detected in about 3-7% of population but sonographically-in ten times more. Thyroid nodular disease is usually asymptomatic and is not associated with disturbances in thyroid function. The key role in the management of this pathology is to detect malignancy. Ultrasound examination of the thyroid combined with fine-needle aspiration biopsy is the most effective means of diagnostics. While benign lesions may be treated conservatively, malignant nodules and those of suspected malignancy have to be managed surgically. Suppressive treatment with L-thyroxine in the light of current guidelines remains controversial. Radioisotope therapy is to be limited to patients with hyperthyroidism and selected cases of non-toxic multinodular goiter. The purpose of the following review is to summarize the basal and actual guidelines related to the diagnosis and treatment of thyroid nodular disease.