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The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

The Parathyroid Glands

The Parathyroid Glands

The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...

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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

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Thyroid tissue remnants after "total thyroidectomy".

V D'Andrea¹, V Cantisani, A Catania

¹Sapienza University of Rome, Department of Surgical Sciences.

Il Giornale Di Chirurgia

|September 9, 2009

Summary

This summary is machine-generated.

Total thyroidectomy (TT) aims for complete thyroid removal but often leaves tissue remnants. A study found over a third of "total thyroidectomies" were not truly complete, impacting recurrence rates.

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

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Published on: September 15, 2023

Area of Science:

Endocrinology
Surgical Oncology
General Surgery

Background:

Total thyroidectomy (TT) is a standard surgical procedure for thyroid pathologies.
While TT offers advantages like reduced recurrence, its completeness is debated.
Existing literature lacks precise methods for quantifying thyroid tissue remnants post-surgery.

Purpose of the Study:

To assess the actual extent of thyroid tissue removal in patients undergoing total thyroidectomy.
To quantify thyroid tissue remnants using colour echo-doppler imaging.
To evaluate the accuracy of 'total thyroidectomy' in clinical practice.

Main Methods:

A cohort of 102 patients who underwent total thyroidectomy for benign thyroid conditions was studied.
Colour echo-doppler imaging of the thyroid lodge was used to detect and measure residual thyroid tissue.
Patients were categorized based on the size of remaining thyroid tissue remnants.

Main Results:

Significant thyroid tissue remnants were detected in 33.3% (34 out of 102) of patients after TT.
Only 66.7% (68 patients) truly had a total thyroidectomy.
11.76% had near total thyroidectomy (<1 cm remnants) and 21.57% had subtotal thyroidectomy (≥1 cm remnants).

Conclusions:

The study highlights that a substantial proportion of total thyroidectomies are not technically complete.
Residual thyroid tissue after TT can range from small remnants to significant portions, resembling near total or subtotal thyroidectomy.
These findings underscore the need for improved surgical techniques and accurate post-operative assessment to ensure complete thyroid removal.