Beyond clinical examination, all patients with NT-MNG should have serum thyrotropin (TSH) measured to assess functional thyroid status and ultrasound (US) examination to evaluate the number, size, and sonographic features of the nodules and assist in the selection of nodules that may need fine-needle aspiration biopsy [5]. Conventional radiography of the trachea and of the esophagus or, even better, computed tomography (CT) or magnetic resonance imaging (MRI) can be used to confirm compression, especially in symptomatic patients [6]. Patients with nodules yielding malignant cytology should be referred for surgery. Given the lack of reliable markers to predict biological behavior of nodules with indeterminate cytology, patients with such nodules are generally addressed to surgery, unless autonomous function of these nodules can be confirmed by scintigraphy.

Some typical morphological and functional images of patients with NT-MNG are showed in Figs. 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, and 10.7.