Current treatment of nodular goiter with hyperthyroidism (Plummer's disease): Surgery versus radioiodine

Kang, Ajaipal S.; Grant, Clive S.; Thompson, Geoffrey B.; Heerden, Jon A. van

doi:10.1067/msy.2002.128691

Cited by 65 publications

(54 citation statements)

References 18 publications

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“…It has been reported to range between 0.5% and 16.6% in patients with Graves disease, 2.5%-12% in patients with TNG, and 1.6%-16.0% in patients with TMNG (4,(30)(31)(32)(33)(34). The discrepancy in thyroid cancer prevalence in hyperthyroidism has been explained by differences in treatment strategies, surgical approach, and extent of histopathological examination of the removed thyroid tissue in different centers.…”

Section: Discussionmentioning

confidence: 99%

Thyroid malignancy risk in different clinical thyroid diseases

Dirikoç¹,

Fakı²,

Başer³

et al. 2017

Turk J Med Sci

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Background/aim: To evaluate the malignancy risk of thyroid nodules in different clinical thyroid diseases. Materials and methods:Patients who underwent thyroidectomy between 2007 and 2014 were grouped as euthyroid, hypothyroid, and hyperthyroid. Further classification was made depending on the presence of solitary/multiple thyroid nodules.Results: Among 2870 patients, 1719 (59.9%) were euthyroid, 962 (33.5%) were hyperthyroid, and 189 (6.6%) were hypothyroid. Overall malignancy was detected in 980 (34.1%) patients. Malignancy rates were 42.1%, 42.9%, and 18.3% in the euthyroid, hypothyroid, and hyperthyroid groups, respectively (P < 0.001). A total 41.4% of patients with euthyroid nodular goiter (ENG) and 46.3% of patients with euthyroid multinodular goiter (EMNG) had thyroid malignancy (P = 0.169). Mean tumor size and capsular and vascular invasion were significantly lower in EMNG than in ENG. Among hypothyroid patients, 45.7% with solitary and 42.2% with multiple nodules were malignant (P = 0.705). When toxic nodular goiter and toxic multinodular goiter were analyzed together, malignancy rate was 24.7% (104/421), and when Graves with nodule/nodules was considered, it was 19.7% (59/299). Conclusion:In hypothyroid or euthyroid patients who underwent thyroidectomy, malignancy rate was higher than 40%, and was lower in hyperthyroid patients. Patients with multiple nodules carry a similar risk of malignancy as patients with solitary nodules, independent of the functional status.

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Section: Discussionmentioning

confidence: 99%

Thyroid malignancy risk in different clinical thyroid diseases

Dirikoç¹,

Fakı²,

Başer³

et al. 2017

Turk J Med Sci

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“…Insgesamt hat in der chirurgischen Therapie der Autonomie in den vergangenen Jahrzehnten die Radikalität des Eingriffs zugenommen. Dies hat den Vorteil einer deutlich verminderten Rezidivrate und den Nachteil einer erheblichen Zunahme postoperativer Hypothyreosen sowie der damit verbundenen Substitutionspflicht mit Schilddrüsenhormon [10]. Minimal-invasive Schilddrüsenchirurgie ist im Fall einer unifokalen Autonomie möglich, sofern das Volumen des Schilddrüsenlappens 15-20 ml nicht überschrei-tet und der zu entfernende Schilddrüsen-knoten nicht mehr als 2 cm misst [13].…”

Section: Schilddrüsenchirurgieunclassified

Prävention und multimodale Therapie der Hyperthyreose

Palitzsch

2008

Internist

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Subclinical and overt hyperthyroidism have been associated with various negative clinical outcomes as for example an increased risk of atrial fibrillation or increased cardiovascular mortality, especially in old age. In order to avoid hyperthyroidism it is strongly recommended not to start any iodine containing drug therapy or to avoid application of contrast agents unless the patient presents with an unremarkable clinical course. TSH suppressive therapy for the treatment of endemic goiter or differentiated low risk thyroid carcinoma is unnecessary, since it favours the development of subclinical hyperthyroidism. Overt hyperthyroidism is treated with antithyroid drugs and/or radioiodine therapy or surgery according to the underlying disease (toxic nodular goiter, Graves' disease).

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“…For this purpose, the choice drug is MMI in a dose of 10-30 mg/day. Relapse following TT is less than 1%, and indications for TT include thyroid dysfunction, compressive symptoms (dyspnea and dysphagia), suspected or confirmed malignancy, and intrathoracic or substernal goiter (70,87,88) (D,D,B). As TA is characterized by single lesions, TP by means of total lobectomy (removal of the nodule-affected lobe, and extension of resection through the isthmus up to the contralateral lobe) is indicated (70,87,88) (D,D,B).…”

Section: Indications For Thyroidectomy In Patients With Tmng or Tamentioning

confidence: 99%

“…However, when hyperthyroidism relapses following TP or TST, completion of TT is indicated after the assessment of the remaining thyroid lobe by means of US (70) (D). If treatment with 131 I is chosen instead, the remaining tissue must be evaluated as to the presence of nodules, and whenever they are found, the nodules should be assessed following the recommended criteria (13,70,87,88) (D,D,D,B).…”

Section: Indications For Thyroidectomy In Patients With Tmng or Tamentioning

confidence: 99%

Consenso brasileiro para o diagnóstico e tratamento do hipertireoidismo: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

Maia

Scheffel

Meyer

et al. 2013

Arq Bras Endocrinol Metab

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SIntroduction: Hyperthyroidism is characterized by increased synthesis and release of thyroid hormones by the thyroid gland. Thyrotoxicosis refers to the clinical syndrome resulting from excessive circulating thyroid hormones, secondary to hyperthyroidism or due to other causes. This article describes evidence-based guidelines for the clinical management of thyrotoxicosis. Objective: This consensus, developed by Brazilian experts and sponsored by the Department of Thyroid Brazilian Society of Endocrinology and Metabolism, aims to address the management, diagnosis and treatment of patients with thyrotoxicosis, according to the most recent evidence from the literature and appropriate for the clinical reality of Brazil. Materials and methods: After structuring clinical questions, search for evidence was made available in the literature, initially in the database Medline, PubMed and Embase databases and subsequently in SciELO -Lilacs. The strength of evidence was evaluated by Oxford classification system was established from the study design used, considering the best available evidence for each question. Results: We have defined 13 questions about the initial clinical approach for the diagnosis and treatment that resulted in 53 recommendations, including the etiology, treatment with antithyroid drugs, radioactive iodine and surgery. We also addressed hyperthyroidism in children, teenagers or pregnant patients, and management of hyperthyroidism in patients with Graves' ophthalmopathy and various other causes of thyrotoxicosis. Conclusions: The clinical diagnosis of hyperthyroidism usually offers no difficulty and should be made with measurements of serum TSH and thyroid hormones. The treatment can be performed with antithyroid drugs, surgery or administration of radioactive iodine according to the etiology of thyrotoxicosis, local availability of methods and preferences of the attending physician and patient. Arq Bras Endocrinol

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Current treatment of nodular goiter with hyperthyroidism (Plummer's disease): Surgery versus radioiodine

Cited by 65 publications

References 18 publications

Thyroid malignancy risk in different clinical thyroid diseases

Thyroid malignancy risk in different clinical thyroid diseases

Prävention und multimodale Therapie der Hyperthyreose

Consenso brasileiro para o diagnóstico e tratamento do hipertireoidismo: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

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