Abstract
Hot and hyperfunctioning thyroid gland nodules are currently treated primarily by radioiodine or surgical resection. In recent years local thermal ablation as an alternative therapeutic modality is increasingly recommended. This article reports the case of a patient with a hot thyroid nodule, which was resected and turned out to be follicular thyroid cancer. In this context it appears to be necessary to critically question thermal ablation as an alternative treatment option for thyroid nodules, particularly since the current recommendations are weak with low or even very low evidence. Radioiodine or surgery remains the first-line treatment for hot and hyperfunctioning thyroid nodules but malignancy in a hot thyroid nodule also needs to be considered.