What are the key clinical features that suggest a thyroid nodule may be malignant?

The key clinical features that suggest a thyroid nodule may be malignant include specific symptoms, physical findings, and patient characteristics ¹.

• Unexplained hoarseness or voice change associated with a thyroid mass ¹. This symptom may suggest tumour invasion of the recurrent laryngeal nerve ¹.
• Cervical or supraclavicular lymphadenopathy associated with a thyroid mass ¹. The presence of cervical lymph nodes ipsilateral to the thyroid nodule may indicate thyroid malignancy ¹.
• Sudden onset of a rapidly expanding painless thyroid mass, significantly increasing in size over days and weeks ¹. This can be a rare presentation of anaplastic thyroid cancer or thyroid lymphoma ¹.
• Associated compressive symptoms, such as breathlessness or dysphagia ¹.
• The presence of other red flags or risk factors for malignancy ¹.
• In children, thyroid nodules are more likely to be malignant than in adults ¹.
• A family history or specific ultrasound appearance suggesting medullary thyroid cancer (MTC) ².