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The dearth of high-quality evidence on the natural history of benign thyroid nodules is surprising. In this prospective study from eight Italian referral centers, researchers assembled a cohort of 992 consecutive euthyroid patients with 1567 thyroid nodules that measured 4 to 40 mm in largest diameter. All nodules were either cytologically benign on fine-needle aspirate (FNA) or were <10 mm in size with benign characteristics on ultrasound. During 5 years of annual thyroid ultrasound examinations, FNA was performed if a previously benign-appearing nodule developed suspicious features on ultrasound or if a nodule grew substantially (11% of nodules increased in volume by at least 50% during follow-up).
Thyroid cancer was diagnosed during follo…