Treatment of toxic solitary thyroid nodules: Surgery versus radioactive iodine

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

Research output: Contribution to journalArticle

40 Scopus citations

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 - Dec 1992

ASJC Scopus subject areas

  • Surgery

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    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.