Behavior of benign multinodular goiter and options for its treatment

Authors

Keywords:

nodular goiter, therapeutics, thyroid diseases.

Abstract

Introduction: Multinodular goiter is the endocrine disease that most frequently requires surgical intervention.
Objective: Describe the behavior of benign multinodular goiter and the options for its treatment.
Methods: Descriptive, observational, cross-sectional study in 277 patients treated in the thyroid disease's clinic of the Central Military Hospital "Dr. Carlos J. Finlay", in the period from January 2008 to December 2018, with a diagnosis of benign multinodular goiter. Variables analyzed: Age, sex, functional status of the thyroid, treatment used, surgical technique used, complications of chemical ablation and complications of surgical treatment. Absolute and relative frequencies were calculated for all variables.
Results: Benign multinodular goiter occurred more frequently in the age group between 45-54 years (38.6%), female sex predominated (80.9%). Euthyroid thyroid status was present in 84% of patients. The most frequently used treatment was chemical ablation (56% of patients). The most frequently performed surgical technique was total thyroidectomy (62.8%).
Conclusions: Benign multinodular goiter occurs more frequently in patients between 35 and 64 years of age, with a predominance of females. Non-toxic multinodular goiter is the most common and the more used treatment is chemical ablation with ethanol. Cervical pain is the most common side effect and there are no serious complications related to this treatment.

Downloads

Download data is not yet available.

References

1. TanerUnlu M, Kostek M, Aygun N, Isgor A, UludagM. Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment [Internet]. Med Bull Sisli Etfal Hosp. 2022;56(1):21-40. DOI: 10.14744/SEMB.2022.56514

2. Grani G, Sponziello M, Pecce V, Ramundo V, Durante C. Contemporary Thyroid Nodule Evaluation and Management [Internet]. The Journal of Clinical Endocrinology & Metabolism. 2020; 105(9):2869-83. DOI:10.1210/clinem/dgaa322

3. Tumino D, Grani G, Di Stefano M, Di Mauro M, Scutari M, Rago T, et al. Nodular Thyroid Disease in the Era of Precision Medicine [Internet]. Front. Endocrinol. 2020; 10:907. DOI: 10.3389/fendo.2019.00907

4. Alkabban FM, Patel BC. Nontoxic Goiter [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. [acceso:25/01/2024]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK482274/

5. Latif S, Altaf HN, Waseem S, Farooqui F, Altaf OS, Amir M. A retrospective study of complications of total thyroidectomy; is it a safe approach for benign thyroid conditions [Internet]. JPMA. 2019; 69(10): 1470-3. DOI:10.5455/JPMA.301233

6. Rojo Quintero N, Suárez Sori BG, Rondón Martínez E, Durruthy Willsom O, Valladares Lorenzo R. Enfermedad nodular de tiroides, incidencia y correlación citohistológica [Internet]. Revista Archivo Médico de Camagüey. 2016 [acceso: 21/05/2022]; 20(3): 299-308. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552016000300010

7. Patel KN, Yip Linwah, Lubitz CC, Grubbs EG, Miller BS, Shen W, et al. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults [Internet]. Annals of Surgery. 2020; 271(3): e21-e93. DOI: 10.1097/SLA.0000000000003580

8. Knobel M. Which is the ideal Treatment for Benign Diffuse and Multinodular Non-Toxic Goiters? [Internet]. Front Endocrinol. 2016 [acceso: 21/05/2022]; 7:48. Disponible en: https://doi.org/10.3389/fendo.2016.00048

9. Orellano P, Dos Santos G, Kapitan M, Botto G, Silva J, Seoane E, et al. Resultados a corto plazo del tratamiento con 131 I en el bocio multinodular: valor adicional de la estimulación previa con rhTSH [Internet]. Rev Chil Endo Diab. 2020 [acceso: 25/07/2022]; 13(3): 110-17. Disponible en: https://pesquisa.bvsalud.org/gim/resource/fr/biblio-1117582

10. Mariani G, Tonacchera M, Grosso M, Fiore E, Falcetta P, Montanelli L, et al. The role of nuclear medicine in the clinical management of benign thyroid disorders, part 2: nodular goiter, hypothyroidism, and subacute thyroiditis [Internet]. Journal of Nuclear Medicine. 2021;62(7):886-95. DOI: 10.2967/jnumed.120.251504

11. Hegedüs L, Frasoldati A, Negro R, Papini E. European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules [Internet]. Eur Thyroid J. 2020;9(4): 194-204. DOI: 10.1159/000506513

12. Perez CLS, Fighera TM, Miasaki F, Mesa Junior CO, Paz Filho GJD, Graf H, et al. Evaluation of percutaneous ethanol injections in benign thyroid nodules [Internet]. Arquivos Brasileiros de Endocrinologia & Metabologia. 2014 [acceso: 21/05/2022]; 58(9): 912-17. Disponible en: https://doi.org/10.1590/0004-2730000003444

13. Miracle-López S, Rodríguez-Ayala E, Alanís CAS. Tratamiento con inyección percutánea con etanol (PEIT) de nódulos tiroideos sólidos benignos. Eficacia y experiencia en México [Internet]. Rev Mex Endocrinol Metab Nutr. 2020; 7: 113-21. DOI: 10.24875/RME.20000015

14. Felício JS, Conceição AMS, Santos FM, Sato MMM, Bastos FdA, Braga de Souza ACC, et al. Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules [Internet]. Front. Endocrinol. 2016; 7:52. DOI: 10.3389/fendo.2016.00052

15. Alcântara-Jones DMD, Borges LMB, Nunes TFA, Pita GB, Rocha VB, Lavinas JM, et al. Percutaneous injection of ethanol for thyroid nodule treatment: a comparative study [Internet]. Archives of Endocrinology and Metabolism. 2021 [acceso: 21/05/2022]; 65(3): 322-7. Disponible en: https://doi.org/10.20945/2359-3997000000363

16. Kumar GS, Rao DN. Comparative Study of Total Thyroidectomy and Subtotal Thyroidectomy Regarding the Surgical Management of Multinodular Goiter [Internet]. IJSS Journal of Surgery. 2018; 4(5): 1-5. DOI: 10.17354/SUR/2018/162

17. Barczynski M, Konturek A, Hubalewska-Dydejczyk A, Golkowski F, Nowak W. Ten-Year Follow-Up of a Randomized Clinical Trial of Total Thyroidectomy Versus Dunhill Operation Versus Bilateral Subtotal Thyroidectomy for Multinodular Non-toxic Goiter [Internet]. World J Surg. 2018; 42(2): 384-92. DOI: 10.1007/s00268-017-4230-1

18. Chohan MZ, Sajid Y, Naeem M, Nizami KM. Comparison of Total and Subtotal Thyroidectomy in Multinodular Goiter [Internet]. Age. 2019 [acceso: 25/07/2022]; 13(3): 36-50. Disponible en: https://www.pjmhsonline.com/2019/july_sep/pdf/576.pdf

19. Mauri G, Pacella CM, Papini E, Solbiati L, Goldberg SN, Ahmed M, et al. Image-guided thyroid ablation: proposal for standardization of terminology and reporting criteria [Internet]. Thyroid. 2019; 29(5): 611-18. Disponible en: https://www.liebertpub.com/doi/full/10.1089/thy.2018.0604

20. Mesa Izquierdo O, Valdés Serrat LM, Barrios Cruz D, Matos Ramos YA, Travieso Peña G. Comportamiento quirúrgico de las patologías del tiroides [Internet]. Rev Cubana Cir. 2020 [acceso: 25/08/2022];59(1):e894. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932020000100006&lng=es

21. Puerto Lorenzo JA, Torres Ajá L, Cabanes Rojas E. Comportamiento de la enfermedad nodular tiroidea en la provincia de Cienfuegos [Internet]. Rev Cubana Cir. 2021 [acceso: 22/07/2022]; 60(4): e_1174. Disponible en: http://www.revcirugia.sld.cu/index.php/cir/article/view/1174

22. Solarana-Ortíz J, Lorenzo-Díaz J, Santiesteban-Collado N, Rodríguez-Pascual Y, Batista-Pérez R, Cuello-Bermúdez E. Caracterización de pacientes operados de la tiroides en los dos hospitales provinciales de Holguín [Internet]. Correo Científico Médico. 2021; 25(4): [aprox. 7 p]. Disponible en: http://revcocmed.sld.cu/index.php/cocmed/article/view/4048

23. Aíras-Cañizares J, Puerto-Lorenzo J, Torres-Aja L. Caracterización de pacientes operados de nódulos benignos de tiroides. Hospital Dr. Gustavo Aldereguía Lima. Cienfuegos, 2014-2019 [Internet]. Medisur. 2022 [acceso: 22/07/2022]; 20(5): [aprox. 7 p]. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/view/5393

Downloads

Published

2024-08-03

How to Cite

1.
Lorda Galiano L, Navas Igarza JO, Licea Videaux M, Hidalgo Herrera M. Behavior of benign multinodular goiter and options for its treatment. Rev Cubana Med Milit [Internet]. 2024 Aug. 3 [cited 2025 Jan. 8];53(3):e024043949. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/43949

Issue

Vol. 53 No. 3 (2024): July - September

Section

Clinical Practice Article

License

Authors who have publications with this Journal accept the following terms:

  • The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
  • The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
  • Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.

Most read articles by the same author(s)