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Andrew J Bauer Division of Endocrinology and Diabetes, The Children’s Hospital of Philadelphia, Department of Pediatrics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Jonathan D Wasserman Division of Endocrinology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada

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Steven G Waguespack Department of Endocrine Neoplasia and Hormonal Disorders and Department of Pediatrics-Patient Care, University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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The 2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma ( 1 ) were developed by a task force comprising well-respected, expert clinicians with good representation of the

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Johannes Järhult Department of Surgery, Highland Hospital, Eksjö, Sweden
Department of Surgery, County Hospital Ryhov, Jönköping, Sweden

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Ramtin Vedad Department of Surgery, County Hospital Ryhov, Jönköping, Sweden

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Introduction Palpable goitre has a prevalence of 10-30% in middle-aged women in the Western world [ 1 , 2 , 3 , 4 , 5 ] and, with modern ultrasound, thyroid nodules have been found in 30-70% of the adult population [ 6 , 7 ]. This implies that

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Marco Marino Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy

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Maria Laura Monzani Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Giulia Brigante Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Katia Cioni Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Bruno Madeo Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Daniele Santi Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Antonino Maiorana Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy

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Stefania Bettelli Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy

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Valeria Moriondo Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy

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Elisa Pignatti Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy

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Lara Bonacini Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Cesare Carani Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy

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Vincenzo Rochira Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Manuela Simoni Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy
Azienda USL of Modena, Modena, Italy

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considered a diagnostic marker of PTC [ 1 ]. The wide clinical use of ultrasound (US) [ 5 ] allows detecting an increasing number of nodules that often require fine needle aspiration biopsy (FNAB) for ruling out thyroid cancer [ 6 ]. As the diagnostic value

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Haggi Mazeh Department of Surgery, Jerusalem, Israel

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Amir Orlev Department of Surgery, Jerusalem, Israel

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Ido Mizrahi Department of Surgery, Jerusalem, Israel

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David J. Gross Endocrinology and Metabolism Service Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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Herbert R. Freund Department of Surgery, Jerusalem, Israel

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(CT) scan of the neck. On CT, a left thyroid lobe nodule was identified with no other findings in the neck. Subsequent ultrasonography demonstrated a multinodular goiter with a dominant nodule at the inferior pole of the left lobe measuring 26 × 27

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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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subgroup consisted of 516 patients of whom thyroid weights were known in 416 patients (81%). Patients with surgery for benign nodule/goiter volume-related complaints are expected to be represented in this subgroup. Therefore, thyroid weight in this patient

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Mitsuaki Tokumaru Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan

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Kenji Ohba Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Kennichi Kakudo Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi, Japan

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Takafumi Suda Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Yutaka Oki Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Yoshie Goto Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan

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hospital visit. Palpation revealed a painless, firm, 2.5 × 2.0-cm nodule on the right side of her neck. Thyroid function tests revealed a euthyroid status. Anti-thyroglobulin and anti-thyroperoxidase antibodies levels were high (1,490 IU/mL [reference range

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Rémy Louvel Head and Neck Surgical Oncology Department, Institut Curie, PSL University, Paris, France

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Nathalie Badois Head and Neck Surgical Oncology Department, Institut Curie, PSL University, Paris, France

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Jerzy Klijanienko Pathology Department, Institut Curie, PSL University, Paris, France

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Ségolène Hescot Medical Oncology Department, Institut Curie, PSL University, Paris, France

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Caroline Hoffmann Head and Neck Surgical Oncology Department, Institut Curie, PSL University, Paris, France

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showing displaced benign thyroid tissue within the muscular fibers. Hematoxylin–eosin–safran, 100×. (C) CT scan, arrows show the subcutaneous nodules, the invasion of the sternocleidomastoid muscle, and the right thyroid compartment. We performed

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Emilio Fiore Department of Experimental and Clinical Medicine, Endocrinology Unit 1, University Hospital of Pisa, Pisa, Italy

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Francesco Latrofa Department of Experimental and Clinical Medicine, Endocrinology Unit 1, University Hospital of Pisa, Pisa, Italy

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Paolo Vitti Department of Experimental and Clinical Medicine, Endocrinology Unit 1, University Hospital of Pisa, Pisa, Italy

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with PTC than in those with adenomatous goiter or follicular adenoma. Ott et al. [ 40 , 41 ] reported a high incidence of thyroid carcinoma (32%) in 146 patients with HT and solitary cold nodules. However, other studies yielded conflicting results

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Daniela Cavaco Department of Endocrinology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Sara Carvalhal Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Valeriano Leite Department of Endocrinology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal

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investigate the cervical nodule, which was a hard, but not adherent, supraclavicular node 5 cm in diameter. There was no evidence of compressive signs such as dysphagia or dyspnea. Thyroid gland palpation revealed a soft nodule of 1.5 cm in the left lobe. The

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Luigino Dal Maso Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy

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Daniela Pierannunzio National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy

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Silvia Francisci National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy

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Angela De Paoli Epidemiological Department, Azienda Zero, Padova, Italy

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Federica Toffolutti Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy

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Salvatore Vaccarella Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France

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Silvia Franceschi Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy

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Rossella Elisei Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy

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Ugo Fedeli Epidemiological Department, Azienda Zero, Padova, Italy

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of the DEPTH Working Group
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diagnostic pressure, namely fine-needle aspiration biopsies of thyroid nodules, were reported at the population level in some Italian areas after 2014 ( 24 ). Meanwhile, the growth in thyroid cancer surgery previously registered in Italy leveled off after

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