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Thyroid nodules remain a common surgical issue. Their surgical management consists of a thyroid lobectomy or a total thyroidectomy. Surgical management entails a certain degree of surgical risk, most notably, injury to the superior or recurrent laryngeal nerves with their concomitant voice changes. There are currently no published guidelines describing a surgical approach to solitary nodules in the isthmus of the thyroid. There have been clinical case reviews and retrospective reviews but the current guidelines have not changed for the management of thyroid isthmus nodules. The current American Thyroid Association (ATA) guidelines do not recommend an isthmusectomy for a malignant nodule. This case report describes our surgical isthmusectomy for management of an isolated nodule in the isthmus of the thyroid gland. This surgical endeavour was purely for cosmetic purposes and patient preference as the nodule was benign. The low risk of surgical complications associated with this procedure makes this an attractive proposition in the management of isthmus nodules. Future developments should include a multicentre randomised control trial to look at the oncological viability of a thyroid isthmusectomy for malignant nodules. It is hoped that this case report will contribute to the armamentarium of surgical endocrine surgeons in the management of nodules of the thyroid isthmus.

Thyroid isthmusectomy for a benign nodule of the thyroid isthmus, a case report