eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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6/2013
vol. 9
 
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abstract:

Clinical research
Role of cytological characteristics of benign thyroid nodules on effectiveness of their treatment with levothyroxine

Mustafa Cesu
,
Mehtap Akcil
,
Sibel Ertek
,
Rifat Emral
,
Safak Bulut
,
Sevim Gullu
,
Demet Corapcioglu

Arch Med Sci 2013; 9, 6: 1083–1089
Online publish date: 2013/12/26
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Introduction: Levothyroxine (LT4) therapy has been used for the treatment of euthyroid nodular goiter, but there are controversial results about its usefulness. We aimed to evaluate the possible role of benign nodules’ cytological characteristics in response to LT4 therapy.

Material and methods: In total, 93 patients with 128 nodules were included in the study; 74 of the nodules were treated with LT4 (group 1), and 54 of them had no medication (group 2). The subgroups consisted of adenomatous nodules, colloid nodules and cystic nodules.

Results: In group 1, mean thyroid volume and mean nodule volume were reduced significantly (p = 0.002 and p = 0.022, respectively) with low-normal level thyrotropin (TSH) suppression (between 0.3 mIU/ml and 1.0 mIU/ml), while there were no significant changes in group 2. When we evaluated changes of the initial and last nodule volumes in cytological subgroups, only colloid nodules in group 1 had significant reduction (p = 0.040) and the others had no significant changes. By omitting the colloid nodules, when the other nodules were revaluated, there were no significant changes in either group.

Conclusions: On the basis of these results, obtained from a large sample of Anatolian patients, it is possible that LT4 therapy leads to significant reductions of both thyroid volume and nodule size in colloid nodules, but not in other kinds of benign nodules.
keywords:

levothyroxine suppressive therapy, nodule treatment, colloid nodule, cystic nodule, adenomatous nodule, thyroid nodule, cytological features, levothyroxine

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