Show description

A high rate of recurrence has been reported after subtotal thyroidectomy for MNG (10% to 30%). 9 months. 4%. Predictive factors for recurrence were female gender, the presence of multiple nodules in the resected thyroid, and a lack of postoperative LT4 therapy. The authors suggested that these factors should be considered to determine an individualized surgical strategy. For patients with history of radiation exposure or a family history of thyroid cancer, total thyroidectomy should be considered independent of the extent of goiter.

All three modalities have roles according to the clinical situation and patient preference, differing in the risks of the therapy themselves as well as the risks of recurrence of clinical hyperthyroidism. Pharmacologic Therapy Antithyroid drugs are frequently used as initial therapy in patients diagnosed with Graves’ disease. The most common antithyroid drugs are thionamides, which include methimizole and propylthiouracil. They work primarily by inhibiting the oxidation and organic binding of thyroid iodide.

These scans have a particular role when considering a limited operation in the presence of hyperthyroidism. In a patient with a MNG and concomitant Graves’ disease, the scan shows globally enhanced uptake. In most patients with MNG, the scan demonstrates a heterogeneous uptake pattern that includes cold and hot areas, which is typical for multinodular thyroid disease. Radionuclide imaging may also be used when treatment with iodine 131 (131I) is being considered. Chest radiography (posteroanterior and lateral views) should be obtained to evaluate the position of the trachea (Figure 2-2).