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MULTINODULAR GOITRE PRESENTING AS A CLINICAL SINGLE NODULE: HOW EFFECTIVE IS HEMITHYROIDECTOMY?
Author(s) -
Wadström Carl,
Zedenius Jan,
Guinea Ana,
Reeve Tom,
Delbridge Leigh
Publication year - 1999
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1046/j.1440-1622.1999.01485.x
Subject(s) - medicine , multinodular goitre , nodule (geology) , thyroid , histopathology , thyroidectomy , multinodular goiter , radiology , surgery , histopathological examination , pathology , paleontology , biology
Background : Patients who present with a single thyroid nodule that requires surgery will generally undergo hemithyroidectomy. If, however, the subsequent histological examination shows unsuspected multinodular change, there is a risk of recurrence in the remaining lobe. The aim of this study was to determine the clinical outcome in patients who have had a hemithyroidectomy for a single thyroid nodule that was shown on subsequent histopathological examination to be part of a multinodular goitre. Methods : A survey was undertaken of patients who were identified from a thyroid surgery database with the following criteria: (i) hemithyroidectomy for clinical single nodule; and (ii) multinodular change on histopathology. Main outcome measures were clinical recurrence rate, the frequency of further thyroid surgery, and the efficacy of thyroxine treatment on recurrence. Results : In the 229 patients studied, the clinical recurrence rate was 12%. Fourteen of the 28 patients with recurrence required further surgery. Thyroxine therapy did not influence the recurrence rate. Conclusion : When surgery for a clinically benign single thyroid nodule is indicated, hemithyroidectomy is an adequate surgical procedure in cases where the single nodule is subsequently found to be part of a multinodular goitre. Such patients can be reassured that the chance of clinical recurrence is low. Thyroxine replacement therapy appears not to prevent recurrence.