A 67-year-old woman presented to her general practitioner with a swelling in her neck. It had been present for 4C5 years and had not changed in size during that time. She was completely asymptomatic and remained well.
On examination, there was a nodular goitre and no lymphadenopathy.
Investigations:
serum thyroid-stimulating hormone1.1 mU/L (0.4C5.0)
A subsequent ultrasound scan demonstrated seven nodules bilaterally (ranging in size from 5 mm to 15 mm), which had no suspicious features.
What is the most appropriate next step in management according to British Thyroid Association 2014 Guidelines for the Management of Thyroid Cancer?
A . fine-needle aspiration of largest nodule
B . levothyroxine 100 micrograms daily
C . radioactive iodine
D . reassure and discharge
E . subtotal thyroidectomy
Answer: D
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