The extent of surgery for unilateral nodular goiter with compression syndrome against the background of autoimmune thyroiditis

Abstract

Introduction. Nodular goiters are clinically recognizable enlargements of the thyroid gland characterized by structural and/or functional transformation of one or several areas within the normal thyroid tissue. In the absence of thyroid dysfunction, autoimmune thyroid disease, thyroiditis, and thyroid malignancy, they constitute an entity described as simple nodular goiter. The objective of the study was to determine the scope of surgery in patients with unilateral nodular goiter with autoimmune thyroiditis (NGAIT) with compression syndrome and predict the long-term results of surgical treatment, based on the study of proliferation of apoptosis and autoimmune disorders. Materials and methods. Long-term results of hemithyroidectomy were analysed in 101 women aged between 23-72 years, with unilateral NGAIT. We analysed the volume of the gland lobe and the echo structure variant before surgery, blood levels of thyroid-stimulating hormone (TSH), free thyroxine and triiodothyronine, thyroid peroxidase antibodies (TPOab), apoptosis and proliferation indicators showing satisfactory or unsatisfactory treatment results. Results. In 75 patients, three years after hemithyroidectomy, no thyroid dysfunction was detected. At ultrasound, in the remaining thyroid the signs of autoimmune thyroiditis (AIT) did not progress. Twenty-six patients showed an increase in the remaining thyroid gland and progression of the autoimmune disease, with hypothyroidism. Conclusions. Hemithyroidectomy can be performed in patients with NGAIT and compression syndrome in conditions of preserved gland function, activation of proliferation and apoptosis, and pseudo micronodular parenchymal echo structure.

Keywords

• nodular goiter
• autoimmune thyroiditis
• apoptosis
• proliferation