Thyroid mass

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) 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

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • Nil

To contact the relevant service, please see HealthPathways: Acute ENT Assessment

Presenting issues
  • Suspected or confirmed malignancy
  • Compressive symptoms including:
    • Changing voice
    • Difficulty in breathing
    • Dysphagia
  • Progressive increase in known benign nodule >1cm-1.5cm  
Mandatory referral information (referral will be returned if this information is not included)

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

  • No additional investigations required before referral

For all other patients:


  • Current medication list including antiplatelet and/or anticoagulants


  • USS +/- FNA results (include provider and date)
  • TSH and T4

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Highly desirable referral information
  • Family history of thyroid cancer
  • Previous head/neck malignancy
  • Previous head/neck radiation treatment  
Indicative triage category
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 category 3 criteria
Excluded ENT services

Referral to public adult ENT outpatient services is not routinely accepted for the following conditions:

Condition Details
Thyroid mass

Excluded condition for the following:

  • Non-bacterial thyroiditis
  • Uniform enlarged gland suggestive of thyroiditis without other symptoms
Last reviewed: 24-05-2023

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