Surgically treated Hashimoto's thyroiditis

The primary way to treat Hashimoto's thyroiditis is conservative. However, it has a relatively high occurrence in operated patients, up to 13% in the literature. Indications for surgery are suspicion of malignancy, and/or trachea/esophagus compression. 2818 thyroid operations were performed at our department between 1986 and 1995. 279 patients suffered from thyroid cancer and 2539 had benign disease. Histology revealed Hashimoto's thyroiditis in 118 cases. Coexisting malignant thyroid tumor was found in 14 cases (11.8%): 9 papillary, 2 follicular, 1 anaplastic cancer, and 2 non-Hodgkin lymphoma. Postoperative recurrent laryngeal nerve paralysis occurred in 8 cases, of which 6 remained permanent. This relatively high incidence supports the importance to identify the laryngeal nerve during every operation for Hashimoto's thyroiditis. Four patients had temporary and one had permanent hypoparathyroidism. Coexistence of Hashimoto's thyroiditis and thyroid carcinoma, the increased risk for the development of non-Hodgkin's lymphoma in chronic lymphocytic thyroiditis and the need for thyroxin supplementation in many cases justify a careful, long-term follow-up of patients with Hashimoto's disease.