Recurrent thyrotoxicosis following near-total thyroidectomy.

Area of Science:

• Endocrinology
• Surgical Oncology
• Nuclear Medicine

Background:

• Total thyroidectomy is a standard surgical procedure for managing hyperthyroidism, typically resulting in a cure.
• Levothyroxine hormone replacement is initiated post-thyroidectomy to maintain euthyroid status.

Observation:

• A 27-year-old woman presented with recurrent thyrotoxicosis approximately two years after a near-total thyroidectomy, despite levothyroxine therapy.
• Diagnostic imaging revealed vascularized thyroid tissue in the right thyroid region with increased radioactive iodine uptake.

Findings:

• The patient's recurrent hyperthyroidism was confirmed off levothyroxine therapy.
• Ultrasound and radioactive iodine scan identified residual, functional thyroid tissue as the source of thyrotoxicosis.

Implications:

• This case underscores the possibility of thyrotoxicosis recurrence after near-total thyroidectomy due to residual thyroid tissue.
• It emphasizes the need for vigilant long-term monitoring of thyroid function in patients who have undergone thyroid surgery.
• Management strategies may include antithyroid medication and radioactive iodine therapy for recurrent hyperthyroidism.