Multinodular goitre presenting as a clinical single nodule: how effective is hemithyroidectomy?

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Disease Management

Background:

• Hemithyroidectomy is standard for single thyroid nodules requiring surgery.
• Unsuspected multinodular change post-surgery carries recurrence risk in the remaining lobe.
• Assessing outcomes for hemithyroidectomy in cases of initially single nodules with later multinodular goiter findings is crucial.

Purpose of the Study:

• To evaluate the clinical outcome of patients undergoing hemithyroidectomy for a single thyroid nodule.
• To determine the recurrence rate and need for further surgery when the nodule is part of a multinodular goiter.
• To assess the efficacy of thyroxine treatment in preventing recurrence.

Main Methods:

• Retrospective survey of patients from a thyroid surgery database.
• Inclusion criteria: hemithyroidectomy for a clinical single nodule with confirmed multinodular change on histopathology.
• Outcome measures: clinical recurrence rate, subsequent surgery frequency, and thyroxine treatment effect.

Main Results:

• A clinical recurrence rate of 12% was observed in 229 studied patients.
• Fourteen out of 28 patients with recurrence required additional thyroid surgery.
• Thyroxine therapy demonstrated no significant impact on recurrence rates.

Conclusions:

• Hemithyroidectomy is an adequate surgical approach for clinically benign single thyroid nodules later identified as part of a multinodular goiter.
• Patients can be reassured regarding a low probability of clinical recurrence after this procedure.
• Thyroxine replacement therapy does not appear to prevent recurrence in this patient cohort.