A 48-year-old woman has a 1.7-cm intermediate-suspicion thyroid nodule. FNA cytology is Bethesda III, TSH is normal and there are no suspicious lymph

Question

A 48-year-old woman has a 1.7-cm intermediate-suspicion thyroid nodule. FNA cytology is Bethesda III, TSH is normal and there are no suspicious lymph nodes. She strongly prefers to avoid diagnostic surgery if risk can be clarified. Which next approach is reasonable?

Accepted Answer

Use repeat FNA or validated molecular testing before selecting surgery

Answer

Measure thyroglobulin serially as the definitive malignancy-risk test

Answer

Obtain radioactive iodine scanning because Bethesda III implies autonomy

Answer

Begin levothyroxine suppression and repeat cytology after one year

Answer

Proceed directly to total thyroidectomy because Bethesda III confirms cancer

Suspicious thyroid nodule — ABIM Board MCQ

A 48-year-old woman has a 1.7-cm intermediate-suspicion thyroid nodule. FNA cytology is Bethesda III, TSH is normal and there are no suspicious lymph nodes. She strongly prefers to avoid diagnostic surgery if risk can be clarified. Which next approach is reasonable?