Total thyroidectomy for pressure symptoms in patients with Hashimoto's thyroiditis
It is estimated that background histological evidence of thyroiditis is present in 45% of female and 20% of male autopsy studies in the UK and USA.3 Therefore, background HT is a common additional diagnosis to the primary histopathology.3
HT is usually treated medically with thyroxine,12 and surgery is rarely required – although on occasions it may be required for suspicion of malignancy, pressure symptoms or cosmesis.1
In general, pressure symptoms are a common indication for thyroidectomy, especially in multinodular goitres, and also in other conditions such as large solitary thyroid nodules, solitary thyroid cysts and some thyroid cancers.1
It has been reported that between 5% and 12% of patients with HT will have pressure symptoms.1 However, pressure symptoms in patients with HT as the primary pathology will be an indication for surgery in a minority of those with this disease.
We have observed a group of patients with HT with significant pressure symptoms despite appearing to have relatively small thyroid glands, who benefit from thyroidectomy in relieving their pressure symptoms.
Therefore, the aims of this study were to determine the incidence of pressure symptoms in patients with HT who underwent thyroidectomy and to determine if there is an association between pressure symptoms and thyroid gland size in HT, to better define the indications for surgery in HT.