There is no such thing as a thyroid adenoma that necessitates surgery. Generally, when the tumor is large and there are symptoms of pressure, it is recommended to opt for surgical treatment. Surgery is recommended for adenomas that are functional. Adenomas suspected of malignancy can be treated with surgery, but surgery is not necessary. 1. Large tumor: if the tumor is large, it may cause compression phenomenon, for example, it will compress the trachea, which will easily cause respiratory difficulties; it will compress the esophagus, which will cause swallowing difficulties; it will compress the nerves, which will cause hoarseness and so on, and then it is recommended to choose surgical treatment. 2. Functional adenomas: Surgery is recommended for high-functioning adenomas, which may cause hyperthyroidism in the later stage. 3. Adenoma suspected of malignant transformation: if the tumor increases rapidly in a short time, the movement of the tumor is restricted, there are abnormal symptoms, and the lymph nodes on the same side are enlarged and uneven, it may be the risk of cancer, and it is recommended to be treated by surgery or iodine 131 treatment. Thyroid tumor above these cases are recommended to receive surgical treatment, some special cases do not need surgery, please strictly follow the doctor’s instructions when treatment.