Does thyroxine suppression therapy help to rationalize surgery in benign euthyroid nodules?

BACKGROUND

Nodular thyroid disease is a common endocrine problem. Most thyroid nodules are benign hyperplastic lesions, but 5-20% may be a true neoplasm. It is important to differentiate a benign from a malignant nodule early as the approach to treatment in the two is radically different. Early institution of medical management in a benign nodule may obviate the need for surgery.

PURPOSE OF THE STUDY: The present work aims to study the efficacy of thyroxine suppression in the management of benign thyroid nodules.

MATERIALS AND

METHODS

A prospective study on patients presenting with thyroid nodule was undertaken. The diagnostic work-up included a clinical evaluation, thyroid function tests, thyroid scintigraphy and fine needle aspiration cytology. Based on the investigations, patients were segregated in Group A (toxic nodular goiter), Group B (benign euthyroid nodule) and Group C (malignant nodule). Group A patients were managed with antithyroid drugs and radioiodine and Group C patients were managed surgically. Group B patients were put on thyroxine suppression. Patients who failed to show reduction in size of the nodule at 18 months were treated surgically.

CONCLUSION

The response rate of benign euthyroid nodule to thyroxine suppression was 76% in the present study.