In general, a solitary thyroid nodule is more likely to be malignant than a multiple nodule or nodular goiter. Patients with the following manifestations should be alerted to the possibility of cancerous nodules. 1. In non-endemic areas with endemic goiter, 10%-50% of single thyroid nodules in children under 14 years of age are malignant. However, all are well-differentiated thyroid carcinomas. 2. A single nodule in the thyroid gland of an adult male. 3.A thyroid nodule that has existed for many years and has increased significantly in a short period of time. 4.The chance of a single nodule being cancerous is much higher in patients living in coastal areas than in patients from endemic goiter areas. Patients who have received radiation therapy to the head and neck during childhood are more likely to have a single nodule in the thyroid. The nodules are hard, irregularly fixed or with enlarged ipsilateral cervical lymph nodes. Vocal cord paralysis. The nodules are “cold nodules” on the thyroid nucleus scan, with a 20% chance of malignant lesions. 8.B ultrasound examination is solid or cystic, with uneven internal echogenicity, unclear and irregular borders, and gravel-like calcifications in the nodule. 9.Tumor cells are found by puncture examination.