Thyroidectomy for Hashimoto's thyroiditis: complications and associated cancers.
BACKGROUND
Hashimoto's thyroiditis is usually treated medically; however, thyroidectomy is sometimes indicated. Thyroiditis can make thyroid dissection more difficult and possibly increase the risk of surgical complications. The aim of this study was to determine the rate of complications and associated cancer in patients with Hashimoto's thyroiditis.


METHODS
Retrospective series of 474 patients treated surgically at the University of California, San Francisco, between January 1985 and June 2005 with final pathology demonstrating Hashimoto's thyroiditis, chronic lymphocytic thyroiditis, or chronic thyroiditis. Parameters evaluated included demographics, surgical indications, and postoperative complications.


RESULTS
Among the 474 patients, 133 had thyroidectomy because of preoperative diagnosis of thyroid cancers (median age 39 years; 116 females and 17 males), 316 had thyroidectomy because of benign thyroid nodules or goiter (median age 47.5 years; 292 females and 24 males), and 25 had thyroidectomy to relieve local symptoms caused by thyroiditis but did not have thyroid nodules (median age 42 years; 25 females). No death or permanent surgical complications occurred. One hundred and fifty-two patients (32.1%) had transient postoperative hypocalcemia, 2 (0.4%) had transient recurrent nerve palsy, and 4 (0.8%) had a postoperative neck hematoma. Fifty-three percent had thyroid cancer at final histological examination.


CONCLUSIONS
Thyroidectomy can be performed in patients with Hashimoto's thyroiditis with a low risk of permanent surgical complications. Cancer is common in patients who have a thyroidectomy for Hashimoto's thyroiditis even when not suspected preoperatively.
Shih
Ming-Lang
ML
Division of General Surgery, Department of Surgery, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Lee
James A
JA
Hsieh
Chung-Bao
CB
Yu
Jyh-Cherng
JC
Liu
Hsaio-Dung
HD
Kebebew
Electron
E
Clark
Orlo H
OH
Duh
Quan-Yang
QY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D050031:Hashimoto Disease / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000209:etiology; D013965:Thyroidectomy; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology