Column 5. Indication for Surgery of Nodular Goiter

Nodular goiter indicates an enlarged thyroid by solitary or multiple nodules in the normal thyroid. In a broader definition, this includes malignant nodules, but it normally refers to benign or indeterminate nodules. Their indications for surgery have been presented variously in textbooks and reviews, but none of them are based on manifest evidence. Solitary nodular goiters due to follicular tumor and adenomatous goiter are often encountered in daily medical practice, but their indications for surgery are individually decided by each institution. In this committee, consensus was obtained about the standards of consultation for surgical indication of nodular goiter from non-surgeons to surgeons. However, the final decision for surgery should not be based on whether nodules meet any one criteria, but should be reasoned in a comprehensive manner (Figs. 1 and 2).