1)      Unexplained neck lump of recent onset

2)      Unexplained persistent swelling in the parotid gland

3)      Unexplained persistent swelling in the submandibular gland

4)      Thyroid lumps with tracheal compression

5)      Thyroid swelling with a solitary nodule of increasing size

6)      Thyroid swelling with past neck irradiation

7)      Thyroid swelling with family history of endocrine tumor

8)      Thyroid swelling with unexplained hoarseness or voice changes

9)      Thyroid swelling with cervical lymphadenopathy

10)    Thyroid swelling in pre-pubertal patients

11)    Thyroid swelling in persons above 65 yrs

Notes :

1)      In patients with thyroid swelling and absence of any of above red flags do thyroid function tests.  Goiter with hyper or hypo thyroidism is unlikely to be malignant.

2)      See also under Goiter