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Related Concept Videos

Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

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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...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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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...
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Goiter01:27

Goiter

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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...
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Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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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...
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Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

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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,...
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The Thyroid Gland01:23

The Thyroid Gland

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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...
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Related Experiment Video

Updated: Apr 23, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Total thyroidectomy or hemithyroidectomy for differentiated thyroid carcinoma?

Jennifer L McGarry1, Alexandra Zaborowski1, Nicola McShane1

  • 1Department of Breast and Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin, Ireland.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|April 21, 2026
PubMed
Summary
This summary is machine-generated.

Optimal surgery for differentiated thyroid cancer (DTC) involves understanding factors for completion thyroidectomy. Male sex and adverse features predict residual disease, while papillary histology reduces risk, guiding personalized treatment strategies.

Keywords:
Differentiated thyroid carcinomaThyroid surgeryThyroidectomy

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Pathology

Background:

  • Surgical management of differentiated thyroid cancer (DTC) lacks consensus on initial hemithyroidectomy versus total thyroidectomy.
  • Identifying predictors for completion thyroidectomy and residual disease is crucial for risk-adapted DTC treatment.

Purpose of the Study:

  • To identify factors predicting the need for completion thyroidectomy in DTC patients initially treated with hemithyroidectomy.
  • To determine clinicopathological predictors of residual disease in the remnant lobe after completion thyroidectomy for DTC.

Main Methods:

  • Multicentre retrospective cohort study of 387 DTC patients (2015-2024).
  • Data collected included demographics, clinical, cytological, and pathological information.
  • Logistic regression analyses were used to identify predictors of completion thyroidectomy and residual disease.

Main Results:

  • Among 243 hemithyroidectomy patients, 71.3% underwent completion thyroidectomy.
  • Residual disease was found in 36.2% of completion thyroidectomy cases.
  • Male sex (OR 4.20) and adverse pathological features predicted residual disease, while papillary histology (OR 0.12) was protective.

Conclusions:

  • Larger nodule size and adverse pathological features correlate with increased completion thyroidectomy rates.
  • Male sex is an independent predictor of residual DTC in the completion lobe, whereas papillary histology indicates a lower risk.
  • Findings support individualized, risk-adapted surgical strategies for DTC, necessitating further prospective research for refined risk prediction.