Rapid Access Thyroid Clinic referrals
The Rapid Access Thyroid Clinic facilitates streamlined and appropriate referral of patients with all thyroid nodules and urgent endocrine surgery at Fiona Stanley Hospital.
It utilises a one-stop model for thyroid nodule assessment where same day clinical consultation, ultrasound, fine needle biopsy and cytology are arranged.
The weekly clinic is attended by specialist thyroid surgeons and has allocation for up to three add-on Category 1 patients weekly, in addition to the current endocrine surgery workload of thyroid, parathyroid and adrenal patients.
Patients meeting the urgent referral criteria below bypass the central waitlist and are seen directly within 1 week of referral via direct telephone contact – see urgent referral instructions below. This allows for more appropriate use of the Rapid Access Neck Lump Clinic for suspected squamous cancers of the head and neck.
Urgent (category 1) referral criteria
Patients with the following conditions are regarded as Category 1 endocrine surgery cases and are eligible for referral.
Thyroid
Thyroid mass with:
- clinically suspicious neck mass
- non-benign cytology
- FDG-PET positive thyroid nodule
- rapid nodule growth
- symptomatic airway compromise or stridor
- unexplained hoarseness or voice change
- cervical lymphadenopathy
- personal history of neck irradiation
- family history of thyroid cancer
- severe Graves’ disease that is medically uncontrollable.
Parathyroid
- Hyperparathyroidism with severe hypercalcemia >3.0
- Hyperparathyroidism in pregnancy
Adrenal
- Adrenocortical cancer or highly suspected adrenocortical cancer
- Large adrenal mass (>4cm)
- Phaeochromocytoma or paraganglioma
- Functional adrenal lesions (Cushing’s / Conn’s syndromes)
Lymph node
- Lymphadenopathy and suspected lymphoma
Exclusions
- Aerodigestive cancer, head and neck cancer, squamous cell cancer.
Urgent referral instructions
- Health professionals are asked to make direct telephone contact with the Endocrine Surgery Fellow/Registrar by phoning the Fiona Stanley Hospital Helpdesk on 6152 2222. If the registrar is unavailable please ask to speak with the Consultant Endocrine Surgeon.
- A written referral should be emailed to the Department of Endocrine Surgery at FSH via e-mail to in addition to the standard central referral system (external site). Your patient will be seen and assessed within 1 to 2 weeks of referral.
- Please print the FSH Rapid Access Thyroid Clinic webpage and give to your patient to explain what they can expect at their appointment.
Routine endocrine surgery referral criteria
Routine endocrine surgery patients who do not meet the urgent referral criteria will be seen at the Rapid Thyroid Access Clinic, usually within 30 days of referral.
Routine referral criteria are as follows:
- incidentally discovered thyroid nodule
- thyroid nodule with inadequate, indeterminate or atypical (follicular neoplasm) cytology
- non-compressive thyroid nodule or goitre
- primary hyperparathyroidism (high serum calcium and high PTH)
- secondary or tertiary hyperparathyroidism due to renal failure
- incidentally discovered adrenal mass (< 4 cm)
- need for lymph node biopsy or splenectomy.
Routine referral instructions
Routine referrals to the clinic must follow the process below.
- Referrals must be submitted using the WA Health general adult referral form (external site).
- Referrals must include documentation of the referral criteria that has been met and a relevant medical history.
- Please fax referrals directly to FSH Referrals on 6152 9762 marked ‘Routine referral to Rapid Access Thyroid Clinic’
More information
Health professionals should phone the Fiona Stanley Hospital Helpdesk on 6152 2222 between 8:30am to 4:00pm, Monday to Friday and ask to be connected to the Endocrine Surgery fellow/registrar.