Treatment of toxic solitary thyroid nodules

Surgery versus radioactive iodine

Timothy O'Brien, Hossein Gharib, Vera Jean Suman, Jon A. van Heerden

Research output: Contribution to journalArticle

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Abstract

Background. Because of controversy about the correct treatment of toxic solitary thyroid nodules, we reviewed our experience. Methods. We retrospectively studied 32 patients (24 women and 8 men) with solitary toxic thyroid nodules who were treated at our institution (1970 to 1985). Results. Median values were as follows: age of patients at initial treatment, 67.6 years (range, 18.9 to 86.2 years); follow-up, 3.8 years; largest diameter of nodules, 3.3 cm (range, 1.5 to 6 cm); and 131I uptake at 24 hours, 31% (range, 7% to 54%). Nine patients had surgical treatment: subtotal thyroid lobectomy in six patients and subtotal thyroidectomy in three patients. Hypothyroidism developed in two of these nine patients (22%) 9 months after operation. No surgical complications occurred. No surgically treated patient had nodule recurrence or required re-treatment. Twenty-three patients were treated with radioactive iodine (median dose, 29.1 mCi; range, 19.7 to 100 mCi). Two of them were re-treated: one patient underwent thyroid lobectomy because of concern about the nodule, and one patient was re-treated with radioactive iodine because of persistent toxicity. Hypothyroidism was detected in eight of the 23 patients (35%) treated with radioactive iodine after treatment. Of the 16 patients treated with radioactive iodine with at least 1 year follow-up and no re-treatment, nine (56.3%) have had complete regression of the nodule. Conclusions. Surgical excision of solitary toxic thyroid nodules would appear to be the treatment of choice.

Original languageEnglish (US)
Pages (from-to)1166-1170
Number of pages5
JournalSurgery
Volume112
Issue number6
StatePublished - 1992

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Thyroid Nodule
Poisons
Iodine
Therapeutics
Hypothyroidism
Thyroid Gland
Thyroidectomy

ASJC Scopus subject areas

  • Surgery

Cite this

O'Brien, T., Gharib, H., Suman, V. J., & van Heerden, J. A. (1992). Treatment of toxic solitary thyroid nodules: Surgery versus radioactive iodine. Surgery, 112(6), 1166-1170.

Treatment of toxic solitary thyroid nodules : Surgery versus radioactive iodine. / O'Brien, Timothy; Gharib, Hossein; Suman, Vera Jean; van Heerden, Jon A.

In: Surgery, Vol. 112, No. 6, 1992, p. 1166-1170.

Research output: Contribution to journalArticle

O'Brien, T, Gharib, H, Suman, VJ & van Heerden, JA 1992, 'Treatment of toxic solitary thyroid nodules: Surgery versus radioactive iodine', Surgery, vol. 112, no. 6, pp. 1166-1170.
O'Brien, Timothy ; Gharib, Hossein ; Suman, Vera Jean ; van Heerden, Jon A. / Treatment of toxic solitary thyroid nodules : Surgery versus radioactive iodine. In: Surgery. 1992 ; Vol. 112, No. 6. pp. 1166-1170.
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abstract = "Background. Because of controversy about the correct treatment of toxic solitary thyroid nodules, we reviewed our experience. Methods. We retrospectively studied 32 patients (24 women and 8 men) with solitary toxic thyroid nodules who were treated at our institution (1970 to 1985). Results. Median values were as follows: age of patients at initial treatment, 67.6 years (range, 18.9 to 86.2 years); follow-up, 3.8 years; largest diameter of nodules, 3.3 cm (range, 1.5 to 6 cm); and 131I uptake at 24 hours, 31{\%} (range, 7{\%} to 54{\%}). Nine patients had surgical treatment: subtotal thyroid lobectomy in six patients and subtotal thyroidectomy in three patients. Hypothyroidism developed in two of these nine patients (22{\%}) 9 months after operation. No surgical complications occurred. No surgically treated patient had nodule recurrence or required re-treatment. Twenty-three patients were treated with radioactive iodine (median dose, 29.1 mCi; range, 19.7 to 100 mCi). Two of them were re-treated: one patient underwent thyroid lobectomy because of concern about the nodule, and one patient was re-treated with radioactive iodine because of persistent toxicity. Hypothyroidism was detected in eight of the 23 patients (35{\%}) treated with radioactive iodine after treatment. Of the 16 patients treated with radioactive iodine with at least 1 year follow-up and no re-treatment, nine (56.3{\%}) have had complete regression of the nodule. Conclusions. Surgical excision of solitary toxic thyroid nodules would appear to be the treatment of choice.",
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