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Rony Ruben Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, India

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Praveen V. Pavithran Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, India

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V. Usha Menon Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, India

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Vasantha Nair Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, India

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Harish Kumar Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, India

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necessary to predict the risk of persistence or recurrence of disease after initial therapy seen in about 12–29% [ 3 , 4 ]. In 1996, the American Thyroid Association (ATA) published treatment guidelines for patients with thyroid nodules and DTC [ 5

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Niko W. de Jong Dutch Association of Graves’ Patients

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G.M. Baljet Royal Dutch Pharmacists Association (KNMP), Amersfoort, The Netherlands

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explanation because the effect of the ageing population is just three times greater than the effect of the general population growth. Third, the Dutch College of General Practitioners (Nederlands Huisartsen Genootschap) published in 2006 guidelines for the

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F. Cecoli Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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E.M. Ceresola Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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V. Altrinetti Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa

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M. Cabria Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa

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M. Cappagli Endocrine Unit, Sant'Andrea Hospital, La Spezia

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A. Montepagani Endocrine Unit, Sant'Andrea Hospital, La Spezia

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C.M. Cuttica Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa

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U. Filippi Evangelico Internazionale Hospital, Genoa

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D. Saverino Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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M. Raffa Endocrine-Metabolic Center, ASL 1, Imperia, Italy

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M. Caputo Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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F. Minuto Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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M. Giusti Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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M. Bagnasco Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa

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from observation to total thyroidectomy [ 10 ]. MPTC mortality rate is very low, ranging from 0.2 to 2.2%. The 2015 American Thyroid Association Thyroid Cancer Management Guidelines [ 11 ] state that active surveillance ‘can be considered' as an

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Brigitte Decallonne Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium

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Annick Van den Bruel Department of Endocrinology, General Hospital St Jan, Bruges, Belgium

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Gilles Macq Department of Research, Belgian Cancer Registry, Brussels, Belgium

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Nathalie Elaut Department of Research, Belgian Cancer Registry, Brussels, Belgium

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Harlinde De Schutter Department of Research, Belgian Cancer Registry, Brussels, Belgium

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surprising and suggested disbelief in FNA and/or surgery being a substitute for FNA [ 2 ]. The 2006 and 2009 international guidelines emphasized the benefit of FNA [ 3 - 5 ]. However, to date, limited evidence is available regarding the local adherence to

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Jeppe Lerche la Cour Center for Endocrinology and Metabolism, Department of Internal Medicine, Herlev and Gentofte Hospitals, Herlev, Denmark

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Line Tang Møllehave Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Denmark

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Bjarke Røssner Medici Center for Endocrinology and Metabolism, Department of Internal Medicine, Herlev and Gentofte Hospitals, Herlev, Denmark

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Christian Zinck Jensen Center for Endocrinology and Metabolism, Department of Internal Medicine, Herlev and Gentofte Hospitals, Herlev, Denmark

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Anne Ahrendt Bjerregaard Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Denmark

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Birte Nygaard Center for Endocrinology and Metabolism, Department of Internal Medicine, Herlev and Gentofte Hospitals, Herlev, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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GPs, due to the lack of evidence of treatment effect in large-scale randomized clinical trials. Guidelines suggest that L-T4 is standard therapy. If symptoms persist after normalization of TSH, combination therapy with L-T3 may be considered an

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Francesco Quaglino General Surgery Unit, Turin, Italy

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Valentina Marchese General Surgery Unit, Turin, Italy

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Enrico Mazza Endocrinology and Metabolism Unit, Turin, Italy

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Cristina Gottero Endocrinology and Metabolism Unit, Turin, Italy

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Riccardo Lemini General Surgery Unit, Turin, Italy

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Stefano Taraglio Pathology Unit, Maria Vittoria Hospital ASL TO2, Turin, Italy

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material, irrespective of the staining method used. Adequacy was evaluated according to guidelines published by the Papanicolaou Society [ 13 ] and Goellner et al. [ 14 ]. Aspirates that fell short of the adequacy criteria were designated “nondiagnostic

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Maria Rossing Department of Endocrinology, Herlev University Hospital, Herlev
Center of Genomic Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Birte Nygaard Department of Endocrinology, Herlev University Hospital, Herlev

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Finn Cilius Nielsen Center of Genomic Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

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Finn Noe Bennedbæk Department of Endocrinology, Herlev University Hospital, Herlev

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cost-effective assessment of thyroid nodules to reduce superfluous surgery; however, preoperative assessment of thyroid nodules is still a diagnostic challenge. Recent guidelines recommend that a thyroid ultrasound (US) should be performed in all

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Suvi Turunen Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Marja Vääräsmäki Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Maarit Leinonen Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland

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Mika Gissler Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden

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Tuija Männistö Northern Finland Laboratory Centre Nordlab, Oulu, Department of Neurobiology, Care Sciences and Society, Finland Karolinska Institute, Stockholm, Sweden

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Eila Suvanto Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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the potential benefits outweigh the potential harms [ 2 ]. Current American and European guidelines recommend treating overt maternal hypothyroidism with levothyroxine (LT4) and overt hyperthyroidism with antithyroid drugs (ATDs) including

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Taha Yusuf Kuzan Department of Radiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey

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Ceren Canbey Goret Department of Surgical Pathology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey

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, 121 single nodules of 121 patients were included in the study. In this study, the “Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer” by the American Thyroid Association (ATA) was used as the standard of evaluation [ 17

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria ‘S. Maria della Misericordia', Udine

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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respondents clearly deviate from ATA/AACE guidelines that suggest a ‘radioactive iodine uptake when the clinical presentation of thyrotoxicosis is not diagnostic of GD', and affirm that as ‘ultrasonography does not generally contribute to the differential

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