Management of hot thyroid nodules: experience of our department

Malika El Omri; Jemli S; Lazid Sarra; Meherzi Abir; Houas Jihene; Ghammem Monia; Ach Taieb; Kermani Wassim; Abdelkefi Mohamed

doi:10.1530/endoabs.99.EP442

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Endocrine Abstracts (2024) 99 EP442 | DOI: 10.1530/endoabs.99.EP442

ECE2024 Eposter Presentations Thyroid (198 abstracts)

Management of hot thyroid nodules: experience of our department

El Omri Malika ¹ , Jemli S ¹ , Lazid Sarra ¹ , Meherzi Abir ¹ , Houas Jihene ¹ , Ghammem Monia ¹ , Ach Taieb ² , Kermani Wassim ¹ & Abdelkefi Mohamed ¹

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¹ENT department Farhat Hached hospital, Sousse, Tunisia; ²Endocrinology department Farhat Hached hospital, Sousse, Tunisia

Introduction: Hot nodules represent 10% of thyroid nodules. They are defined by scintigraphic examination, which shows areas fixing the radiotracer more intensely than the rest of the gland. The aim of our work is to study the clinical, paraclinical aspects and therapeutic modalities of hot thyroid nodules.

Materials and methods: We report a retrospective study about 45 observations of hot thyroid nodules collected at our department

Results: The average age of our population was 42 years with a sex ratio of 5.4. The nodule was isolated in 28 cases, associated with signs of hyperthyroidism in 17 cases and signs of compression in five cases. The Physical examination revealed a thyroid nodule or isthmolobar located at right in 33 cases and left in 12 cases. The average size of nodule was 3.61 cm. The ultrasound revealed an heterogeneous appearance in 39 cases, homogeneous in six cases, punctiform calcifications in two cases and macrocalcifications in two cases. Thyroid scintigraph showed a completely extinct nodule in 19 cases (42.2%), partially extinguished in six cases (13.3%), not extinguished in 12 cases (26.7%) and necrotic in eight cases (17.8%). Treatment was surgical for 44 patients and radioactive iodine for one patient. Histopathological examination was in favor of benignity in all operated cases.

Conclusions: Hot nodules represent only a small part of hyperthyroidism (2 to 17%). Toxic nodules must be treated because of their cardiac consequences. Surgery is the most cautious in this case, especially in young subjects. The treatment by radioactive iodine is indicated in elderly people or people with a surgical contraindication.