Thyroid nodule 0.4×0.4cm puncture malignant need to be treated through surgery for excision, after surgery with drug therapy, if necessary, radioactive iodine can be used to assist treatment. Clinically found that the thyroid gland 0.4×0.4cm nodule is malignant, need to be removed through surgery as soon as possible. In the process of removing malignant thyroid nodules, part of the surrounding thyroid tissue should also be removed to avoid metastasis and recurrence. After thyroid surgery, patients may suffer from hypothyroidism and need to take medication such as levothyroxine for life to maintain normal levels of thyroid hormones. If there is malignant tissue that has invaded the blood vessels or spread beyond the thyroid gland, radioactive iodine therapy may be used. If the diagnosis of malignant thyroid nodules is made by puncture, it is recommended to consult a doctor for a comprehensive evaluation of the condition and decide on a specific treatment plan.