Surgical Aspects of Goiter with Hashimoto‘s Thyroiditis: Clinical Experience in a Tertiary care center

Dr Dasarathi Murmu; Dr Purna Chandra Panda; Dr Sibaram Mahapatra

Volume : VI, Issue : XII, December - 2017

Surgical Aspects of Goiter with Hashimoto‘s Thyroiditis: Clinical Experience in a Tertiary care center

Dr Dasarathi Murmu, Dr Purna Chandra Panda, Dr Sibaram Mahapatra

Abstract :

Summary: Hashimoto�s thyroiditis (HT) is an organ–specifc autoimmune disease is usually treated conservatively with thyroxine. Thyroidectomy is not generally recommended because the dense inﬂammatory process that surrounds the thyroid gland can make resection more difcult. However, patients with HT are considered for surgery if they experience persistent symptoms after conservative therapy. In our experience with 104 thyroidectomies, 16 cases of goiter with associated HT who underwent thyroidectomy between June 2014 and May 2017 in a tertiary care center IMS & SUM Hospital,Bhubaneswar were analysed for indications of surgery. The mean age of 42.5 years, F:M ratio was 14:2 and 90% were female. Goiter was diffuse in 44% and nodular in 56%, 7 (44%) of patients were hypothyroid. Autoimmune association was found in 12%. Commonest surgery done was thyroid lobectomy in 9 (56%) followed by subtotal thyroidectomy in 4(25%) cases. Most frequent indication for surgery was nodular goiter in 10 (62.5%) followed by pressure symptoms, painful thyroiditis, persistent goite and associated malignancy. Histopathology showed diffuse HT alone in 2 (12%) and rest of the cases had HT as a component with other pathologies. Associated pathologies were benign multinodular goiter (5), colloid nodule (7), cyst(1), follicular adenoma (1). Surgery for HT is primarily indicated for associated pathologies like dominant nodule, pressure symptoms, painful thyroiditis, persistent goiter and suspicious or proven malignancy and rarely for HT alone . Therefore, HT patients should be considered surgery for palliation if they suffer from persistent symptoms after conservative therapy.