Skip to main content

Advertisement

Log in

Indications for surgical treatment in benign thyroid disease

  • Review Article
  • Published:
Hellenic Journal of Surgery

Abstract

The treatment of thyroid cancer involves surgery. However, treatment of benign thyroid disease is debatable. Goitre should be treated by surgery if malignancy is suspected and if there are compressive signs and symptoms. Similarly, true recurrence of goitre should be treated surgically in the case of suspected malignancy and in the case of compressive symptomatology. Thyroid nodules should also be treated surgically if there is suspicion of malignancy and if there are compressive signs and symptoms. Surgery for the treatment of Graves’ disease is indicated in the case of suspected malignancy within a thyroid nodule and in the presence of Graves’ ophthalmopathy. In conclusion, indications for surgical treatment in benign thyroid disease are the suspicion of malignancy, compressive signs and symptoms, and the presence of Graves’ ophthalmopathy in Graves’ disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Krohn K, Führer D, Bayer Y, et al. Molecular pathogenesis of euthyroid and toxic multinodular goiter. Endocr Rev 2005;26:504–24.

    Article  CAS  PubMed  Google Scholar 

  2. Hegedüs L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: current status and future perspectives. Endocr Rev 2003;24:102–32.

    Article  PubMed  Google Scholar 

  3. Führer D, Schmid KW. Benign thyroid nodule or thyroid cancer? Internist 2010;51:611–9.

    Article  PubMed  Google Scholar 

  4. Gharib H, Papini E, Paschke R, et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive Summary of recommendations. J Endocrinol Invest 2010;33:287–91.

    Article  CAS  PubMed  Google Scholar 

  5. Paschke R, Reiners C, Führer D, Schmid KW, Dralle H, Brabant G. Recommendations and unanswered questions in the diagnosis and treatment of thyroid nodules. Opinion of the Thyroid Section of the German Society for Endocrinology. Dtsch Med Wochenschr 2005;130:1831–6.

    Article  CAS  PubMed  Google Scholar 

  6. Karges W, Dralle H, Raue F, et al; German Society for Endocrinology (DGE) - Thyroid Section. Calcitonin measurement to detect medullary thyroid carcinoma in nodular goiter: German evidence-based consensus recommendation. Exp Clin Endocrinol Diabetes 2004;112:52–8.

    Article  CAS  PubMed  Google Scholar 

  7. Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Ultrasound Q 2006;22:231–40.

    Article  PubMed  Google Scholar 

  8. Bojunga J, Herrmann E, Meyer G, Weber S, Zeuzem S, Friedrich-Rust M. Real-time elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis. Thyroid 2010;20:1145–50.

    Article  PubMed  Google Scholar 

  9. Shoback D. Hypoparathyroidism. N Engl J Med 2008;359:391–403.

    Article  CAS  PubMed  Google Scholar 

  10. Schaffler A. Hormone replacement after thyroid and parathyroid surgery. Dtsch Arztebl Int 2010;107:827–34.

    PubMed Central  PubMed  Google Scholar 

  11. Cappellani A, Di Vita M, Zanghì A, et al. The recurrent goiter: prevention and management. Ann Ital Chir 2008;79:247–53.

    PubMed  Google Scholar 

  12. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab 2008;22:901–11.

    Article  PubMed  Google Scholar 

  13. Gharib H, Papini E. Thyroid nodules: clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am 2007;36:707–35.

    Article  CAS  PubMed  Google Scholar 

  14. Gharib H. Changing trends in thyroid practice: understanding nodular thyroid disease. Endocr Pract 2004;10:31–9.

    Article  PubMed  Google Scholar 

  15. Lee C, Chalmers B, Treister D, et al. Thyroid Lesions Visualized on CT: Sonographic and Pathologic Correlation. Acad Radiol 2014; pii: S1076-6332(14)00314-6.

    Google Scholar 

  16. Cooper DS, Doherty GM, Haugen BR, et al; American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167–214.

    Article  PubMed  Google Scholar 

  17. Baloch ZW, LiVolsi VA, Asa SL, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008;36:425–37.

    Article  PubMed  Google Scholar 

  18. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid 2009;19:1159–65.

    Article  PubMed  Google Scholar 

  19. Cibas ES, Ali SZ; NCI Thyroid FNA State of the Science Conference. The Bethesda System For Reporting Thyroid Cytopathology. Am J Clin Pathol 2009;132:658–65.

    Article  PubMed  Google Scholar 

  20. Castro MR, Espiritu RP, Bahn RS, et al. Predictors of malignancy in patients with cytologically suspicious thyroid nodules. Thyroid 2011;21:1191–8.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Wan H, Zhang B, Wang Y, et al. Clinical role of BRAF V600E mutation testing in thyroid nodules. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014;49:468–72.

    PubMed  Google Scholar 

  22. Paschke R, Hegedüs L, Alexander E, Valcavi R, Papini E, Gharib H. Thyroid nodule guidelines: agreement, disagreement and need for future research. Nat Rev Endocrinol 2011;7:354–61.

    Article  PubMed  Google Scholar 

  23. Gharib H, Papini E, Paschke R, et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. J Endocrinol Invest 2010;33(5 Suppl):51–6.

    CAS  PubMed  Google Scholar 

  24. Gharib H, Papini E, Paschke R, et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. J Endocrinol Invest 2010;33(5 Suppl):1–50.

    CAS  PubMed  Google Scholar 

  25. Gharib H, Papini E, Paschke R, et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract 2010;16:468–75.

    Article  PubMed  Google Scholar 

  26. Peleg M, Fox J, Patkar V, et al. A Computer-Interpretable Version of the AACE, AME, ETA Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract 2014;20:352–9.

    Article  PubMed  Google Scholar 

  27. Gharib H, Papini E, Paschke R. Thyroid nodules: a review of current guidelines, practices, and prospects. Eur J Endocrinol 2008;159:493–505.

    Article  CAS  PubMed  Google Scholar 

  28. Castro MR, Gharib H. Continuing controversies in the management of thyroid nodules. Ann Intern Med 2005;142:926–31.

    Article  PubMed  Google Scholar 

  29. Prabhakar BS, Bahn RS, Smith TJ. Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy. Endocr Rev 2003;24:802–835.

    Article  CAS  PubMed  Google Scholar 

  30. Bahn RS. Graves’ ophthalmopathy. N Engl J Med 2010;362:726–38.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Phitayakorn R, McHenry CR. Incidental thyroid carcinoma in patients with Graves’ disease. Am J Surgs 2008;195:292–7.

    Article  Google Scholar 

  32. Bartalena L. The dilemma of how to manage Graves’ hyperthyroidism in patients with associated orbitopathy. J Clin Endocrinol Metab 2011;96:592–9.

    Article  CAS  PubMed  Google Scholar 

  33. Phitayakorn R, Morales-Garcia D, Wanderer J, et al. Surgery for Graves’ disease: a 25-year perspective. Am J Surg 2013;206:669–73.

    Article  PubMed  Google Scholar 

  34. Hegedüs L, Bonnema SJ, Smith TJ, Brix TH. Treating the thyroid in the presence of Graves’ ophthalmopathy. Best Pract Res Clin Endocrinol Metab 2012;26:313–24.

    Article  PubMed  Google Scholar 

  35. Erdei A, Paragh G, Kovacs P, et al. Rapid response to and long-term effectiveness of anti-CD20 antibody in conventional therapy resistant Graves’ orbitopathy: A five-year follow-up study. Autoimmunity 2014 [Epub ahead of print]

    Google Scholar 

  36. Acharya SH, Avenell A, Philip S, Burr J, Bevan JS, Abraham P. Radioiodine therapy (RAI) for Graves’ disease (GD) and the effect on ophthalmopathy: a systematic review. Clin Endocrinol (Oxf) 2008;69:943–50.

    Article  Google Scholar 

  37. Abraham P, Acharya S. Current and emerging treatment options for Graves’ hyperthyroidism. Ther Clin Risk Manag 2010;6:29–40.

    PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to I. Kostoglou-Athanassiou.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kostoglou-Athanassiou, I. Indications for surgical treatment in benign thyroid disease. Hellenic J Surg 87, 18–23 (2015). https://doi.org/10.1007/s13126-015-0173-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13126-015-0173-x

Key words

Navigation