Thyroid mass Referral Access Criteria

Referrers should use this page when referring patients to public adult ENT outpatient services for thyroid masses.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Airway compromise - stridor/drooling breathing difficulty/acute or sudden voice change/severe odynophagia
  • Acute hoarseness associated with neck trauma or surgery
  • Post-operative neck or upper airway complications
  • Sudden increase in size or pain of known thyroid nodule/cyst 
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):

  • Nil
To contact the relevant service, see HealthPathways: Acute ENT assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Suspected or confirmed malignancy
  • Compressive symptoms including;
    • changing voice
    • difficulty in breathing
    • dysphagia
  • Progressive increase in known benign nodule >1cm-1.5cm   
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History

If patient is eligible for the Fiona Stanley Hospital Rapid Access Neck Lump Clinic:

  • No additional investigations required before referral

All other patients:

  • Current medication list including whether patient is currently taking antiplatelet or anticoagulant medication
Examination
  • Nil
Investigations
  • USS +/- FNA results (include provider and date)
  • TSH and T4
Highly desirable
History
  • Family history of thyroid cancer
  • Previous head/neck malignancy
  • Previous head/neck radiation treatment      
Examination
  • Nil
Investigations
  • Nil
Indicative triage category

Category 1

Appointment within 30 days

  • Cytology confirmed malignancy or suspicious FNA or dominant nodule > 4cm on USS
  • Compressive symptoms e.g. dyspnoea, hoarseness or dysphagia

Category 2

Appointment within 90 days

  • Progressive increase in known benign nodule >1cm-1.5cms 

Category 3

Appointment within 365 days

  •  No defined category 3 criteria
Exclusions
  • Excluded condition for the following:
    • Non-bacterial thyroiditis
    • Uniform enlarged gland suggestive of thyroiditis without other symptoms
Useful information
  • Nil
Last reviewed: 02-10-2023