A variety of benign entities produce thyroid nodular disease, the two most common being nodular hyperplasia (NH) and follicular adenoma (FA).
NH is non-neoplastic, not requiring surgical excision unless symptomatic.
FA, considered neoplastic, can justify local resection when viewed as a precursor for progression to cancer.
Current molecular testing based solely on mutational analysis or RNA classifier does not differentiate between these or other benign states limiting surgery decision-making.
We show that microRNA (miRNA) profiling can discriminate NH from FA with high accuracy for more informed molecular assessment of cytologically indeterminate nodular disease.