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Management of Thyroid Incidentalomas Encountered by Anesthesiologists and Pain Physicians
  1. Samer Narouze, MD, PhD and
  2. Dmitri Souzdalnitski, MD, PhD
  1. Center for Pain Medicine, Summa Western Reserve Hospital, Cuyahoga Falls, OH.
  1. Address correspondence to: Samer Narouze, MD, PhD, Center for Pain Medicine, Summa Western Reserve Hospital, 1900 Twenty-Third St, Cuyahoga Falls, OH 44223 (e-mail: narouzs{at}


Abstract Unexpected, asymptomatic thyroid lesions incidentally discovered during unrelated diagnostic or therapeutic interventions are called thyroid incidentalomas (TIs). These lesions are extremely common, creating a clinical problem that most anesthesiologists and pain specialists are unfamiliar with. Ultrasonography (US), which allows high-quality real-time visualization of tissues during brachial plexus block, stellate ganglion block, central vascular access, and other interventions, is the imaging modality of choice of many anesthesiologists and pain medicine specialists for therapeutic interventions on the neck. The increasing number of US procedures performed on the neck will eventually result in an upsurge of anesthesiologists and pain specialists encountering a TI. Interventionalists are responsible for acquiring optimal images, accurate needle positioning during interventions, and storage and appropriate labeling of the obtained images. Ignoring the TI or disclosing the presence of a “tumor” can substantially affect the patient’s well-being. In this literature review, we discuss 2 clinical cases of incidentalomas, summarize the current evidence-based strategies, and provide readers with practical guidelines—possibly applicable to other abnormal findings—for the management of incidentally found thyroid lesions.

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  • The authors declare no conflict of interest.

    This work has not been presented at any meeting.

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