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Is partial thyroidectomy definitive treatment for Plummer's disease (autonomous goiter)?
Clinical Nuclear Medicine
|February 1, 1983
Summary
Residual thyroid tissue after surgery for Plummer's disease is common. This can lead to recurrent hyperthyroidism, potentially favoring radioactive iodine therapy over surgery for some patients.
Area of Science:
- Endocrinology
- Thyroidology
- Nuclear Medicine
Background:
- Plummer's disease involves autonomous and normal thyroid tissue.
- Surgery and radioactive iodine (I-131) therapy are standard treatments.
- Disease progression is slow, with late recurrences expected.
Purpose of the Study:
- To evaluate long-term outcomes after thyroidectomy for Plummer's disease.
- To assess the prevalence of residual autonomously functioning thyroid tissue.
- To inform treatment decisions between surgery and I-131 therapy.
Main Methods:
- Retrospective analysis of 87 patients thyroidectomized for Plummer's disease.
- Follow-up period: 1-15 years (average 7.1 years).
- Evaluations included clinical exams, scintigraphy, and TRH tests.
Main Results:
- 21% (18/87) of patients showed localized autonomous function.
- TRH tests were abnormal in 10 of these 18 patients.
- Residual autonomy was more common in males and appeared as residual, not recurrent, tissue.
Conclusions:
- Residual autonomously functioning thyroid tissue is common after surgery for Plummer's disease.
- Recurrent hyperthyroidism may develop in a subset of patients.
- Findings may support considering I-131 therapy in select cases.