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While there is now a lot of scientific information available to meet the needs of healthcare providers, there is not always uniformity and standardization among recommendations. Consequently, the interpretation and application of guidelines in clinical practice remain somewhat limited. In this context, the management of \u201csmall\u201d thyroid nodule warrants full discussion. Looking at treatment guidelines, surgery is the first-line option and the risk of cancer relapse can be assessed only after at least thyroidectomy; in addition, according to guidelines of minimally invasive treatment, thermal ablation may be considered for patients with small classical papillary carcinoma. However, the Thyroid Imaging Reporting And\u00a0Data Systems do not recommend biopsy in nodules less than 1\u00a0cm; and performing biopsy may yield a result that is suspicious or consistent with malignancy without specifying the cancer subtype. With these premises, facing\u00a0cases of \u201csmall\u201d nodule less than 1\u00a0cm is challenging. Even if the recommendations of guidelines sound singularly appropriate, they may seem conflicting. Coordinated guidelines are needed.<\/jats:p>","DOI":"10.1007\/s11154-025-09950-z","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T16:38:26Z","timestamp":1738687106000},"page":"223-227","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Complexity in the interpretation and application of multiple guidelines for thyroid nodules: the need for coordinated recommendations for \u201csmall\u201d lesions"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2125-4937","authenticated-orcid":false,"given":"Pierpaolo","family":"Trimboli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"issue":"7182","key":"9950_CR1","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1136\/bmj.318.7182.527","volume":"318","author":"SH Woolf","year":"1999","unstructured":"Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. 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