Black thyroid: a benign finding

Physical examination revealed a hard stone consistency thyroid nodule fixed to surrounding tissues in the right lobe of approximately 15 mm. Ultrasound revealed a 17×10 mm solid nodule in the right lobe of heterogeneous echogenicity with microcalcifications. Fine-needle aspiration biopsy showed epithelial cell sheets with increased dense chromatin nuclear volume, clefts, evident nucleolus and haematic background suggestive of malignancy (Bethesda IV). [...]they do not affect the gland’s functionality.3 Black thyroids were also reported in cystic fibrosis and less common in hereditary haemochromatosis and ochronosis.4 5 Thyroid neoplasm has been reported in 65% of patients with black thyroid; nevertheless, the high prevalence of malignancy can be explained by the fact that black thyroid is diagnosed during the thyroid malignancy diagnostic workup triggered by the overdiagnosis of thyroid cancer.6 Neither black thyroid nor minocycline has been associated with an increased risk of malignancy or more aggressive cancer.7 Patient’s perspective When they found a nodule in my thyroid and explained that it could be cancer, I was devastated.