Approach to Thyroid Nodule in Elderly: Current State-of-the-Art Review

A bstract Thyroid nodules are common in the elderly, with rising detection due to high-resolution ultrasound and increased life expectancy. While malignancy rates per nodule are lower in this age group, aggressive thyroid cancers are more frequent, complicating management. This review aims to address a tailored clinical approach for older adults, epidemiology, evaluation, and diagnostic tools (such as ultrasound, fine-needle aspiration, and molecular testing) and need for individualized care. Age-related issues like comorbidities and frailty demand individualized care. Treatment options range from observation to surgery, with minimally invasive procedures like ethanol injection and thermal ablation offering alternatives for high-risk patients. International scoring systems aid in risk stratification and decision-making. Comprehensive geriatric assessment is essential to balance treatment benefits and risks. Ultimately, optimal management requires integrating clinical judgment, patient preferences, and evidence-based tools to avoid overtreatment and ensure quality care.