Surgical therapy in Hashimoto's thyroiditis

Area of Science:

• Endocrinology
• Surgical Pathology
• Thyroidology

Background:

• Hashimoto's thyroiditis (HT) is typically managed with levothyroxine (L-T4).
• Some patients develop large goiters unresponsive to L-T4, causing persistent compression symptoms and cosmetic issues.
• Surgical intervention is considered for refractory HT goiters.

Purpose of the Study:

• To evaluate the surgical indications and procedures for managing large goiters in Hashimoto's thyroiditis.
• To assess the efficacy and safety of surgical treatment for HT patients with persistent symptoms despite L-T4 therapy.

Main Methods:

• Retrospective analysis of 13 patients with clinically diagnosed HT and large goiters requiring surgery.
• Evaluation of patient demographics, L-T4 treatment history, and presenting symptoms.
• Surgical procedure involved subtotal thyroidectomy, preserving a small portion of thyroid tissue.

Main Results:

• All 13 patients experienced relief from pressure symptoms and improved neck appearance post-surgery.
• Eight patients with diffusely enlarged goiters had extremely elevated antibody titers.
• No surgical complications were reported in any of the treated patients.

Conclusions:

• Subtotal thyroidectomy is an effective treatment for large goiters in Hashimoto's thyroiditis.
• Surgery provides significant relief for patients with persistent compression symptoms or cosmetic concerns unresponsive to long-term L-T4 therapy.
• Surgical management of HT goiters is safe and resolves debilitating symptoms.