This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endocrinology and breast, Subject name: Surgery
A 45 year old male presents with 4 X 4 cm, mobile right solitary thyroid nodule of 5 months duration. The patient is euthyroid. The following statements about his management are true except 
Select and explain. 
A. Cold nodule on thyroid scan is diagnostic of malignancy, B. FNAC is required in fuher management of patient, C. The patient should undergo hemithyroidectomy if FNAC repo is inconclusive, D. Indirect laryngoscopy should be done in the preoperative period to assess mobility of vocal cords
A: Cold nodule on thyroid scan is diagnostic of malignancy
Answer: A: Cold nodule on thyroid scan is diagnostic of malignancy 
Explanation: Malignancy is present in 15% to 20% of cold nodules and in less than 5% of hot nodules. Although suggestive, malignancy of a nodule can be neither confirmed nor excluded based on radionuclide uptake. Note :Option "Patient should undergo hemithyroidectomy if FNAC repo is inconclusive " is controversial. Close surveillance with ultrasound, genetic and molecular testing or other alternatives to diagnostic thyroidectomy. Even after diagnostic thyroidectomy, patient still requires survelliance for other lobe or may require total thyroidectomy if biopsy proves malignancy.