Invited commentary

Block, Melvin A.

doi:10.1007/bf01561502

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…2). The low probability of hypothyroidism after thyroidectomy at our institution in the early 1950s is similar to that reported in some series [5,15], while the increasing probabilities occurring in the 1960s and 1970s are similar to or higher than rates reported by other authors [3,16]. Although an increasing frequency of posttreatment hypothyroidism in recent decades has been reported with 131I therapy of toxic multinodular goiter [17], we are not aware that a similar finding has been reported after thyroidectomy.…”

Section: Discussionsupporting

confidence: 89%

Treatment of toxic multinodular goiter (hummer's disease): Surgery or radioiodine?

et al. 1986

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The records of patients treated at the Mayo Clinic for toxic multinodular goiter during 1950–1954, 1960–1964, and 1970–1974 were reviewed to compare results of surgical and131I therapy, to define trends in treatment policy and outcome, and to attempt to elucidate factors associated with posttreatment hypothyroidism. The series involved 446 patients who underwent thyroidectomy as initial treatment and 89 who initially received131I. The time to success was significantly shorter (p=0.001) in surgically treated patients than in patients initially receiving131I. Compared with patients treated medically, patients treated initially with surgery were much less likely to require a second treatment (0% versus 24%) during the first year after initial treatment. The probability of postthyroidectomy hypothyroidism increased from approximately 12% in the 1950s to more than 70% in the 1970s at 2 years after surgery. Neither more aggressive surgery nor use of more sensitive tests to diagnose hypothyroidism accounted for the increased probability in recent years.

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Section: Discussionsupporting

confidence: 89%

Treatment of toxic multinodular goiter (hummer's disease): Surgery or radioiodine?

et al. 1986

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Thyroid morphology and function after subtotal resection for hyperthyroidism

Lundström

Norrby

1980

Journal of British Surgery

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Two main patterns of hyperplasia of the thyroid epithelium are seen in hyperthyroidism--toxic diffuse hyperplasia and toxic nodular hyperplasia. Toxic diffuse hyperplasia may affect the entire gland or it may arise in the extranodular tissue in a gland with nodular lesions. A series of patients treated by subtotal thyroidectomy for hyperthyroidism were classified into three morphological groups of goitre: 98 had a toxic diffuse goitre (TDG), 58 toxic nodular goiter with diffuse hyperplasia (TNGDH), and 105 toxic nodular goitre with nodular hyperplasia (TNGNH). The type of goitre was correlated to the development of disturbed thyroid function 1-6 years after surgery. Twenty-two patients with TDG and 18 (31 per cent) with TNGDH developed hypothyroidism; only 3 (3 per cent) with TNGNH showed hypofunction. Six patients with recurrent hyperthyroidism were found; all showed diffuse hyperplasia of the gland. It is concluded that the development of disturbed thyroid function after surgery is closely related to the histopathological type of goitre.

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Invited commentary

Cited by 2 publications

References 8 publications

Treatment of toxic multinodular goiter (hummer's disease): Surgery or radioiodine?

Treatment of toxic multinodular goiter (hummer's disease): Surgery or radioiodine?

Thyroid morphology and function after subtotal resection for hyperthyroidism

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