A 38-year-old woman has a firm 2 cm thyroid nodule noted incidentally, with hoarseness of voice for 6 weeks. What does NICE NG12 advise?
Answer and explanation
Correct answer: C. Urgent referral on the suspected cancer pathway
- Step 1: Hoarseness with a thyroid mass raises suspicion of cancer with laryngeal nerve involvement.
- Step 2: NICE advises urgent referral for an unexplained thyroid lump.
Answer
Urgent referral on the suspected cancer pathway.
Why not the others: Referral to a speech and language therapist only: Speech therapy does not address the cause. Reassurance and a repeat examination in a year: Waiting a year risks delayed diagnosis. A trial of levothyroxine to shrink the nodule over six months: Levothyroxine suppression is not a treatment for suspected cancer.
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