"The follicular adenoma of the thyroid is a common benign tumor of the thyroid gland. They present as a solitary nodule, usually as a painless mass. It may be found during a routine physical examination. A physician may order a nuclear medicine thyroid scan which measures uptake of radionucleotide labelled iodine. Adenomas are usually cold nodules since they usually take up less radioactive iodine than normal surrounding gland. On the other hand, about 10% of cold nodules are malignant. Conversely, hot nodules are only rarely malignant.
Once the nodule is identified, additional diagnostic techniques including an ultrasound examination which may identify a cystic component may be helpful. A pathologist may perform a fine needle aspiration biopsy to obtain diagnostic cytology. In the case of a follicular adenoma, a diagnosis of follicular neoplasm-adenoma versus carcinoma, may be rendered. On cytologic examination, a pathologist cannot make the distinction between an adenoma versus a carcinoma. An excisional biopsy must be obtained. The pathologist must carefully embed the entire capsule in order to exclude capsular invasion, the hallmark of malignancy. "
So it may or may not be cancer - An excisional biopsy must be obtained as far as I can tell.
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