If the thyroid is punctured due to a neck wound, can it be ignored or must it be addressed?

How would you know?: The greater risk is what other injuries may co-exist (e.G trachea, esophagus, blood vessels). If somehow you could prove that then only structure injured was the thyroid gland itself, then it could absolutely be ignored.

Address it: Penetrating injury to the neck usually includes a ct scan of the neck as an initial screening test. Other tests can include bronchoscopy, an upper GI study and possible flexible upper endoscopy. However, there are situations where observation alone is practiced. There is no reason to check thyroid blood work. Most of these injuries will heal without any intervention, but you should see a surgeon.