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operation; KI = inorganic iodine (38 mg iodine daily); another ATD = change to MMI from PTU. * The OP patient died suddenly at home from an unknown cause just a few days before the scheduled total thyroidectomy. The remaining 9 AG patients (36
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. All the patients underwent total thyroidectomy accompanied by a lateral neck dissection due to preoperatively detected LNM. The mean age of the patients was 40.0 ± 16.5 years (range 6-81), with 39 patients (76.5%) being younger than 45 years. The
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Medical Education Center, Hamamatsu University School of Medicine, Shizuoka, Japan
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Department of Pharmacology, Hamamatsu University School of Medicine, Shizuoka, Japan
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gland (Fig. 1 c). These findings were consistent with the profile for a hyperfunctioning thyroid nodule. The patient underwent total thyroidectomy, because multiple lateral lymph node metastases were suspected by the preoperative US (cN1b). The
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NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
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submitted to a total thyroidectomy. A 15-mm follicular variant of PTC (T1bNxMx), without vascular invasion or extra-thyroidal extension, was found and she was started on levothyroxine suppressive treatment. Chest computed tomography (CT) scan detected 4
Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
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Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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the frequently indolent nature of PTMC and the cost and risk of surgery, active surveillance (AS) and ultrasound (US)-guided minimally invasive treatments (MITs) are proposed as alternative management options to thyroidectomy for selected incidental
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With the advent of minimally invasive techniques in thyroid surgery, conventional open-access surgery for bilateral multinodular goiter was extended to encompass total thyroidectomy. At the same time, the surgical approach to the thyroid gland
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a surgical resection of all the nodules and a total thyroidectomy extended to the surrounding infiltrated tissues (Supplementary Fig. 1, see section on supplementary materials given at the end of this article). Histologically, benign thyroid tissue
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Objective: As thionamide is associated with various adverse effects, we reevaluated the practical efficacy of potassium iodide (KI) therapy for Graves’ hyperthyroidism (GD).
Methods: We administered KI (mainly 100 mg/day) to 324 untreated GD patients, and added methimazole (MMI) only to those remaining thyrotoxic even at 200 mg/day. When the patient became hypothyroid, MMI if taken was stopped, then levothyroxine (LT4) was added without reducing the KI dose. Radioactive iodine (RI) therapy or thyroidectomy was performed whenever required. We evaluated the early effects of KI at 2-4 weeks, and followed patients for 2 years.
Results: At 2 weeks, serum thyroid hormone decreased in all 324 patients. At 4 weeks, fT4, fT3, and both fT4 and fT3 levels became normal or low in 74.7%, 50.6%, and 50.6%, respectively. In a cross-sectional survey over 2-years, GD was well-controlled with KI or KI+LT4 (KI-effective) in >50% of patients at all time points. Among 288 patients followed for 2 years, 42.7% remained ‘KI-effective’ throughout 2 years (KI Group), 30.9% were well-controlled with additional MMI given for 1-24 months, and 26.4% were successfully treated with ablative therapy (mainly RI). Among ‘KI-effective’ patients at 4 weeks, 76.5% were classified into KI Group. No patients experienced adverse effects of KI.
Conclusion: KI therapy was useful in the treatment of GD. A sufficient dose of KI was effective in >50% of GD patients from 4 weeks to 2 years, and 42.7% (76.5% of ‘KI effective’ patients at 4 weeks) remained ‘KI-effective’ throughout 2 years.
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the cause in the majority of cases of litigation after thyroidectomy ( 2 , 3 ). The incidence of voice changes after thyroid surgery varies widely. Most published data are derived from centres with large workload and might not be an accurate
Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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Introduction Hypocalcemia after total or completion thyroidectomy occurs in 30–60% of patients and is the result of impaired production of parathyroid hormone (PTH) due to inadvertent resection, bruising, edema, or ischemia of the parathyroid
