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

Indian J Nucl Med. 2010 Apr;25(2):57-61.
Does thyroxine suppression therapy help to rationalize surgery in benign euthyroid nodules?
Mitra S, Jha M, Gandhi K.
Source
Department of Nuclear Medicine, Tata Main Hospital, Jamshedpur - 831 001, India.
Abstract
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.