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Editorial Thyroid Disorders Advancements in Clinical Thyroidology in 2016 Maria Brito and Terry F Davies Icahn School of Medicine at Mount Sinai, New York, US I n this article, we summarize the seminal highlights of clinical thyroidology literature published in 2016. The main focus of these articles were thyroid nodules, thyroid cancer, cubclinical hypothyroidism in pregnancy, Graves’ disease in pregnancy, the American Thyroid Association guidelines for adult patients with thyroid nodules and differentiated thyroid cancer, and the American Thyroid Association guidelines for the diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Keywords Fine needle aspiration, noninvasive follicular thyroid neoplasm with papillary-like nuclear features, tyrosine kinase inhibitor, radiofrequency ablation, ethanol ablation, propylthiouracil Disclosure: Maria Brito and Terry F Davies have nothing to declare in realtion to this article. This article is a short opinion piece and has not been submitted to external peer reviewers. No funding was received for the publication of this article. Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Received: November 3, 2016 Published Online: December 20, 2016 Citation: US Endocrinology, 2016;12(2):83–4 Corresponding Author: Maria Brito, Division of Endocrinology, Diabetes and Bone Diseases, Mount Sinai Beth Israel, 1st Ave at 16th St, Fierman Hall 7th floor, New York, NY 10003, US. E: MBFerreiras@chpnet.org The year 2016 has been an exciting one in the world of thyroid disease, marking a new era for both research and clinical management. As a subspecialty, we are continuously re-evaluating not only our current treatment strategies, but also our classification of disease, right down to adjusting the nomenclature. All of this has occurred within the last year and the impact of many of these changes is requiring clinical endocrinologists to make significant changes in their approach to patient care. Here, we summarize some of the advancements that have clinical relevance. Not surprisingly, in 2016 the majority of the literature explored thyroid nodules and thyroid cancer. 1 We began the year with the publication of the latest American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. 2 In agreement with the review by Kim et al., 3 at the heart of these new guidelines is the indication that we should be doing much less in management and treatment, but with under the premise that patients are thoroughly and appropriately assessed. Highlighting this approach are the recommendations to hold the standard for diagnostic fine needle aspiration (FNA) to the most detailed sonographic characteristics of these nodules, eliminating the >5 mm threshold to FNA for high-risk individuals and suggesting that observing sonographically very low risk nodules without FNA is also a reasonable option, no matter how large the lesion. Although highly suspicious thyroid nodules with a benign cytology should have a repeat FNA within a year, it is now recommended that in very low suspicion nodules we should consider discontinuing surveillance altogether after two benign FNA results. These guidelines have also, at last, added the recommendation of thyroid lobectomy for low-risk thyroid cancer patients with tumors of 1–4 cm in size and strongly recommend lobectomy for sub centimeter thyroid nodules, which can also be closely monitored without surgery as an alternative. Last, but not least, the threshold for administering radioactive iodine (RAI) has been increased significantly, and the routine use of recombinant human thyroid stimulating hormone stimulated thyroglobulin levels has been discouraged in low-risk situations. So, are these guidelines an advancement? The authors should be congratulated for another monumental task and excellent review of the current thyroid nodule and cancer literature. They certainly correct some points from the previous version, but they appear to some of us to err too much on the side of doing nothing. Discontinuing surveillance of nodular thyroids and just providing surveillance for small thyroid cancers remain controversial suggestions. Of course, if only everyone would stop doing FNAs on small nodules then this situation would not need to be discussed. But as long as fee-for-service in the US continues, we can be sure that such patients will continue to present for advice on future management. TOU CH MED ICA L MEDIA 83