Benign thyroid disease

Studies on thyroid tissue obtained at surgery of Benign thyroid disease Malignant thyroid disease... 

As benign thyroid disease can create high costs for public health systems, the benefit of preventing iodine... 

Iodine intake level (based on UI) affects the type of benign thyroid disease (Laurberg et ai, 2001). A number of studies (Laurberg et ai, 2001 Suzuki et al., 1975 Stanbury et ai, 1998) indicated the following specific associations a high iodine intake causes endemic goiter (Suzuki etai, 1975). Aswitch from low to sufficient iodine... 

A history of benign thyroid diseases, mostly goiter and nodules, and long-term residency in iodine-deficient areas have now been considered as established risk factors for thyroid cancer. Pathogenesis of thyroid disease is associated with several genetic alterations. 

Side effects of radioiodine have been few and moderate, particularly in the treatment of benign thyroid diseases, which require less radioactive exposure than thyroid cancer (Dietlein et ai, 2004 Huysmans et al, 1997 Reiners and Schneider, 2002 Sarkar, 2006). A mutagenic risk has not been demonstrated in the followups and appears to be minimal. 

Treatment of Benign Thyroid Conditions Treatment of benign thyroid disease is the most widely used therapy. In the USA, therapy with is the most commonly used treatment for thyrotoxicosis, destroys the overactive thyroid tissue, leaving the patient hypothyroid or euthyroid. 

TSH suppression in well-differentiated thyroid cancer and thyroid nodules -The target level for TSH suppression in these conditions has not been established in controlled studies. In addition, the efficacy of TSH suppression for benign nodular disease is controversial. Therefore, individualize the dose of levothyroxine used for TSH suppression based on the specific disease and the patient being treated. 

Discrimination between benign and malignant thyroid disease... 

As for the natural course of benign nodular thyroid disease, nodules tend to grow slowly but more rapidly than the nonnodular goiter tissue (Quadbeck et ai, 2002) (Figure 81.3). In a study of our own group, half of the nodules displayed a significant increase in size by at least 30% only after a period of 3 years (Quadbeck et ai, 2002) (Figure 81.3). Treatment studies therefore need to address... 

NIS-mediated iodide accumulation allows diagnostic thyroid scintigraphy, as well as therapeutic radioiodine application, in benign and malignant thyroid disease. 

Marotta V, Guerra A, Sapio MR, Vitale M. 2011. RET/PTC rearrangement in benign and malignant thyroid diseases a clinical standpoint. Eur J Endocrinol 165(4) 499-507. 

Although thyroid disorders in patients treated with interferon alfa generally follows a benign course after interferon alfa withdrawal or specific treatment, severe long-lasting ophthalmopathy resulting from Graves disease has been described in a 49-year-old woman (507). 

Thyroid hormone is sometimes used to suppress growth in patients with a benign solitary thyroid nodule and a normal TSH, but such therapy generally is not recommended. Suppression therapy is of no value if the nodule is autonomous, as indicated by a subnormal TSH. Once TSH is suppressed, a radioisotope scan should be performed if significant uptake persists, the gland is non-suppressible and L-T,i therapy should be discontinued. Suppression therapy should not be used in patients with known coronary artery disease, since the risks of precipitating cardiac arrhythmias or angina are considerable. 

---