MANAGEMENT OF THE HOT THYROID-NODULE

BACKGROUND: Solitary hyperfunctioning nodules of the thyroid gland are usually viewed as benign, They may present with autonomous euthyroidi sm but are of concern for potential progression to hyperthyroidism. Va rious methods of treatment are worthy of consideration. PATIENTS AND M ETHODS: Forty-five patients with solitary hot thyroid nodules verified by radioisotope scintiscanning were selected for treatment, Thirty-on e underwent surgery, usually partial thyroidectomy. Eight euthyroid pa tients received no treatment, 5 underwent therapy with radioactive iod ine (RAI), and 1 received thyroid suppression treatment. The cases wer e assessed retrospectively. RESULTS: Thyroidectomy patients had no mor bidity, were well, and showed 1 Hurthle cell tumor and 5 coincidental small malignancies associated with benign hot nodules, including a con tralateral cancer, Untreated patients showed continuance of good healt h, but nodules persisted and 1 Graves' orbititis occurred, The RAI-tre ated patients had persistent nodularity, improved function, and 1 case of hyperparathyroidism. Thyroid feeding only caused iatrogenic toxici ty and was discontinued. CONCLUSIONS: There are various techniques for managing the hot nodule, Nonsurgical methods may be effective, but ca n result in persistent nodularity and iatrogenic sequelae, Excision ha d no morbidity in this series and was effective in providing immediate relief of problems present and potential.