Toxic nodular goiter

BACKGROUND: Although hyperfunctioning thyroid disorders were thought to be protective against malignancy, some recent studies reported a high incidence of incidentally discovered cancer in patients with hyperfunctioning benign thyroid disorders. We performed this study to estimate the incidence and predictors of malignant thyroid disease in patients with toxic nodular goiter (TNG). Patients and Methods . The data of 98 patients diagnosed with TNG were reviewed (including toxic multinodular goiter SMNG and single toxic nodule STN)...

Introduction: Hyperthyroidism is often managed with radioactive iodine therapy. The dose of 131 Iadministered to the patient is determined based on the calculated size of the thyroid gland in gram and 24 hour iodine uptake. Ultrasonography is a validated modality for determination of thyroid volume. Though necessary for assessing degree of 123 I uptake, nuclear scintigraphy also allows for the capability of estimating thyroid volume. Here we compare volume measurements calculated based on ultrasonography and nuclear scintigraphy in a cohort of hyperthyroid patients...

OBJECTIVE: The objective of this disease state clinical review is to provide clinicians with a summary of the nonsurgical, minimally invasive approaches to managing thyroid nodules/malignancy, including their indications, efficacy, side effects, and outcomes. METHODS: A literature search was conducted using PubMed and appropriate key words. Relevant publications on minimally invasive thyroid techniques were used to create this clinical review. RESULTS: Minimally invasive thyroid techniques are effective and safe when performed by experienced centers...

A 62 years old woman was diagnosed with multinodular toxic goiter and primary hyperparathyroidism/left parathyroid adenoma by hormonal assessment, ultrasound and nuclear thyroid/parathyroid scans. Cervical ultrasound illustrated a multinodular aspect of the thyroid with solid nodules and cystic-component nodules; the larger one represented a multinodular complex with necrosis areas in the left thyroid lobe, ACR TI-RADS score 4 (moderately suspicious). Functional nuclear imaging was performed for accurate differential diagnosis between thyroid vs ...

Purpose: To determine the time to euthyroidism and its determinants among thyrotoxicosis patients on anti-thyroid drug attending the medical and ambulatory clinics of South Tigrai General Hospitals, Ethiopia, 2015-2020. Methods: A multi-center retrospective cohort study was conducted from March 30, 2020, to July 30, 2020, among adult thyrotoxicosis patients who received anti-thyroid medications in the medical and chronic ambulatory clinics of South Tigrai General Hospitals, Ethiopia...

The term 'hyperthyroidism' refers to a form of thyrotoxicosis due to inappropriate high synthesis and secretion of thyroid hormone(s) by the thyroid. The leading cause of hyperthyroidism in adolescents is Graves' disease (GD); however, one should also consider other potential causes, such as toxic nodular goitre (single or multinodular), and other rare disorders leading to excessive production and release of thyroid hormones. The term 'thyrotoxicosis' refers to a clinical state resulting from inappropriate high thyroid hormone action in tissues, generally due to inappropriate high tissue thyroid hormone levels...

Thyroid diseases may cause a variety of functional and structural body changes, including eye and vision abnormalities, which can have a negative impact on a patient's well-being. However, only a few studies on the impact of other benign thyroid diseases on the visual process are available in the literature. In this study, using the Polish version of the thyroid-specific quality of life (ThyPROpl) questionnaire, we aimed to determine the self-reported influence of benign thyroid diseases (e.g., nodular goiter, toxic nodular goiter, Graves' disease, thyroid orbitopathy, Hashimoto's thyroiditis, and surgical hypothyroidism) on patients' eyes and vision...

PURPOSE: Toxic multinodular goiter is a heterogeneous disease associated with hyperthyroidism frequently detected in areas with deficient iodine intake, and functioning and non-functioning nodules, characterized by increased proliferation but opposite functional activity, may coexist in the same gland. To understand the distinct molecular pathology of each entity present in the same gland, the gene expression profile was evaluated by using the Affymetrix technology. METHODS: Total RNA was extracted from nodular and healthy tissues of two patients and double-strand cDNA was synthesized...

Background : The objective of this article is to evaluate the outcomes in patients undergoing radioactive iodine (RAI) with adjunctive lithium (Li) therapy versus (vs.) RAI therapy alone for the treatment of hyperthyroidism. Methods : A systematic review of the literature was undertaken to analyze clinical trials comparing RAI with adjunctive Li therapy vs. RAI therapy alone for the treatment of hyperthyroidism. Results : Six randomized-controlled trials (RCT) involving 755 patients were analyzed. RAI with adjunctive Li was associated with a significantly higher cure rate for hyperthyroidism when compared to RAI alone...

BACKGROUND: Toxic nodular goiter (TNG) is a rare disease in which the cause of hyperthyroidism is the presence of a node or nodes that autonomously secrete thyroid hormones. With children and adolescents this condition is extremely rare - in 5-7.5% of all cases of nodular goiter. Therapy of toxic nodular goiter is aimed at relieving the symptoms of hyperthyroidism taking into account the malignant potential of the nodular formation. In the available literature, there are no data on the clinical course, comparative results of cytological and histological data in patients with toxic nodular goiter, which debuted in their childhood...

BACKGROUND: Whole-body oxidative stress can be estimated by the urine excretion of oxidized guanosine species, 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), derived from RNA and DNA, respectively. These oxidative stress markers are not well explored in thyroid disorders. OBJECTIVE: We aimed to determine whether treatment of hyperthyroid patients affects the levels of these oxidative stress markers. METHODS: Urinary excretion of 8-oxoGuo and 8-oxodG was measured in 51 hyperthyroid patients (toxic nodular goiter [TNG], n = 30; Graves disease [GD], n = 21) before or shortly after initiation of therapy and when stable euthyroidism had been achieved for at least 12 months...

Part 2 of this series of Continuing Education articles on benign thyroid disorders deals with nodular goiter, hypothyroidism, and subacute thyroiditis. Together with Part 1 (which dealt with various forms of hyperthyroidism), this article is intended to provide relevant information for specialists in nuclear medicine dealing with the clinical management of patients with benign thyroid disorders, the primary audience for this series. Goiter, an enlargement of the thyroid gland, is a common endocrine abnormality...

Radioiodine therapy (RIT) of thyroid functional autonomy (TFA) is rapidly evolving, though it has been recognized for decades as a very effective treatment of toxic nodular varieties. Indeed, TFA is a frequent cause of persistent subclinical hyperthyroidism, which should be regarded as a new metabolic syndrome, with well-established adverse cardio-vascular consequences. Sensitive TSH assays and multiparametric ultrasounds are not accurate enough to reliably diagnose TFA and identify its main variants, unifocal, multifocal (UFA/MFA) and disseminated autonomy (DISA)...

This research describes a clinical case of treatment of a patient with thyrotoxicosis with concomitant hematological pathology – carriage of unstable hemoglobin Hasharon. A patient diagnosed with «Diffuse toxic nodular goiter. Thyrotoxicosis of medium severity. Drug-induced hypothyroidism» was admitted to the Department of radionuclide therapy for the purpose of treatment with radioactive iodine. Onset of disease - summer 2018 (thyroid-stimulating hormone (TSH) – 0 mIU/ml)...

BACKGROUND: At the time of seeking medical help, some patients have nodular/multinodular goiter of large and gigantic sizes, which leads to compression of the neck organs. In the structure of benign diseases, neck compression is diagnosed in 10% of cases, and tracheal narrowing is found in 84% of patients in this group. It was experimentally established that narrowing of the trachea leads to the development of hypertension in the pulmonary circulation. Patients with nodular/multinodular goiter with compression of the neck organs belong to the age group of 50 years and older, the peculiarity of which is comorbidity of varying severity...

INTRODUCTION: Autonomously functioning thyroid nodules (AFTNs) are generally benign, whereas papillary thyroid carcinomas (PTCs) are mostly non-functioning. Graves' disease (GD) is the most common cause of hyperthyroidism (HD), followed by hyperfunctional adenoma or Plummer's disease. GD with AFTNs is called Marine-Lenhart syndrome, a relatively rare syndrome. In clinical practice, the presence of HD, AFTNs and PTC at the same time is extremely rare. CASE PRESENTATION: Case 1: A 55-year-old middle-aged woman with a preoperative diagnosis of GD and HD with right AFTNs...

OBJECTIVE: Cytochrome b5-reductase (CYB5R) and cytochrome P450 reductase (CYPOR) are important for cell metabolism; however, their role in thyroid hormonogenesis and carcinogenesis has not been elucidated yet. The activity of CYB5R correlates with the metastasis in breast cancer, but there are no similar studies for CYB5R and CYPOR for thyroid tumors. The aim of this study was to elucidate the activity of CYB5R and CYPOR changes in benign euthyroid and hyperthyroid neoplasms and in papillary thyroid cancer for their potential application as biomarkers for diagnosis and prognosis prediction of thyroid cancer...

BACKGROUND: Multinodular goiter is a common disease in population. If only one thyroid lobe is affected, hemithyroidectomy may be preferred to reduce complication and hormone replacement therapy. However, completion thyroidectomy may be required later. The aim of the study was to evaluate the role of completion thyroidectomy in patients who develop nodules after hemithyroidectomy and we aimed to find the ratio of patients who required hormone replacement for permanent hypothyroidism. MATERIALS AND METHODS: The patients who underwent hemithyroidectomy for benign nodular goitre between January 2012 and June 2017 were analysed...

BACKGROUND: Despite the biological link between thyroid hormones and breast cancer cell proliferation shown in experimental studies, little is known about the association between hyperthyroidism and breast cancer, as well as its association with the most common mammographic and genetic risk predictors for breast cancer. METHODS: This study estimates the incidence rate ratios (IRRs) of breast cancer among women diagnosed with hyperthyroidism, compared to those who are not, using two cohorts: a Swedish national cohort of the general female population (n = 3,793,492, 2002-2011) and the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA, n = 69,598, 2002-2017)...

Potential use of sonographic TI-RADS classification combined with circulating miRNA expression profiling in the diagnosis of thyroid nodules was explored. Retrospective analysis was performed on clinical data of 121 patients with thyroid nodules. The biopsy specimens of patients obtained through ultrasound-guided aspiration and blood specimens were evaluated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2018 to June 2019. In addition, the blood specimen test results of 121 healthy volunteers (control group) who underwent physical examination were retrospectively analyzed...