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Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

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...

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...

Goiter

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

Urinary Tract Calculi VI: Surgical Management

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Updated: May 8, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

Surgery for Graves' disease: a 25-year perspective.

Roy Phitayakorn¹, Dieter Morales-Garcia, Jonathan Wanderer

¹Thyroid Cancer Research Laboratory, Endocrine Surgery Unit, The Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, Wang ACC 460, Boston, MA 02115, USA.

American Journal of Surgery

|September 10, 2013

Summary

Thyroidectomy for Graves' disease (GD) is a safe procedure with low complication rates. This study found that surgical treatment for GD has a high safety profile and incidental malignancy is common.

Keywords:

Graves’ disease Incidental malignancy Surgical therapy

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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

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Last Updated: May 8, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

Area of Science:

Endocrinology
Surgical Oncology
Thyroid Surgery

Background:

Optimal treatment for Graves' disease (GD) is debated.
This study retrospectively analyzed surgical GD cases at an academic center.

Purpose of the Study:

To evaluate the safety and outcomes of thyroidectomy for Graves' disease.
To assess perioperative and thyroidectomy-specific morbidity.
To determine the incidence of incidental malignancy in GD patients undergoing surgery.

Main Methods:

Retrospective review of 300 patients with GD undergoing thyroidectomy over 25 years.
Data analyzed across three distinct time periods (1985-2010).
Evaluation of demographic, clinical, and surgical data.

Main Results:

Overall perioperative morbidity was 12.0% with no mortality.
Thyroidectomy-specific morbidity was notably low.
The rate of incidental malignancy detected was 10.3%.

Conclusions:

Thyroidectomy for Graves' disease demonstrates a high safety profile.
The procedure is safe even for patients with overt hyperthyroidism.
Incidental malignancy is a frequent finding in patients with GD undergoing thyroidectomy.