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de Quervain's thyroiditis: surgical experience.

Troy M Duininck1, Jon A van Heerden, Vahab Fatourechi

  • 1Division of Gastroenterologic and General Surgery, Mayo Clinic Rochester, Rochester, Minnesota 55905, USA.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|August 14, 2002
PubMed
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De Quervain

Area of Science:

  • Endocrinology
  • Thyroidology
  • Surgical Pathology

Background:

  • De Quervain's thyroiditis (dQT) is an uncommon inflammatory condition of the thyroid.
  • Medical management is typically the primary treatment approach for dQT.
  • Surgical intervention for dQT is rarely indicated.

Purpose of the Study:

  • To review a 35-year experience with the surgical management of de Quervain's thyroiditis.
  • To evaluate the safety and outcomes of surgical intervention for dQT.

Main Methods:

  • Retrospective review of medical records for patients with dQT treated surgically between 1966 and 2000.
  • Analysis of patient demographics, clinical presentation, indications for surgery, and pathological findings.
  • Review of surgical procedures and postoperative outcomes, including complications and long-term follow-up.

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Main Results:

  • 17 patients (11 female, 6 male; mean age 50) underwent surgery for dQT.
  • Indications for surgery included indeterminate thyroid nodules (14), dysphagia (2), and hyperthyroidism (1).
  • Surgical complications were low, with one case each of temporary vocal cord palsy and hypocalcemia. 14 patients required long-term thyroid hormone replacement therapy.

Conclusions:

  • Surgical resection for de Quervain's thyroiditis can be performed safely with low morbidity.
  • Routine fine-needle aspiration biopsy (FNAB) is likely to reduce the number of patients requiring surgical exploration for dQT.
  • Patients with atypical features or euthyroidism may be more likely candidates for surgical intervention.