[Benign thyroid nodules in the elderly. Medical treatment]

Benign thyroid nodules are a frequent pathology in the general population and in particular in the aged, but their treatment is still controversial. The percentage by which volume and/or the number of nodules is reduced using L-thyroxine treatment reported in the literature varies widely: from 9 to 68%. The aim of this study was to study the therapeutic efficacy of thyroxine treatment in the aged.

A retrospective study was performed in 105 elderly out-patients (mean age 68 +/- 6 years) suffering from thyroid nodules forming part of a population of 7452 thyroid patients from central Italy attending the 2nd Medical Clinic at "La Sapienza" University of Rome from 1986 to 1994. Other diseases which might influence treatment were excluded in all subjects. Thyroid hormones, TSH and antithyroid antibodies were assayed using RIA techniques; patients also underwent ultrasonography of the gland, 131I thyroid captation with scintigraphy and cytological analysis using fine needle aspiration. Patients were treated with L-thyroxine (75-150 micrograms/day) and controlled after 6, 12 and 24 months. No collateral effects were reported.

The majority of patients (some 85%) remained stationary; just under 10% improved and only a few showed a deterioration of symptoms.

Medical therapy continues, in the authors' opinion, to be the first choice in the treatment of benign thyroid nodules also in elderly patients owing to its easy management, low cost and scarce collateral effects.