COURSE on THYROID ULTRASOUND
Section 2 The nodular goiter
Part 5 The borders of the nodule
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The borders of the nodule - case 1115
Clinical data: A 44-year-old woman was referred for evaluation of hyperthyroidism and typical complaints including severe thyroid associated orbitopathy (TAO) including diplopia. 6 years ago. At that time, we suggested thyrostatic therapy and thereafter total thyroidectomy. We did not meet the patient in the previous 6 years. Then she visited us and told what happened. She was afraid of life-long replacement therapy and looked for another surgeon. She has found one who promised her not to perform total thyroidectomy. A bilateral subtotal thyroidectomy was performed, and permanent palsy of the left recurrent nerve has developed. The patient remained euthyroid for the next 5 years without any thyroid medication. She got irradiation and steroid therapy for her TAO with only temporary improvement. One year after thyroid operation she underwent on eye surgery with very good cosmetic and functional results including cessation of diplopia. 2 months before present visit a recurrent hyperthyroidism has developed and unfortunately her diplopia also come forward. Daily 20 mg methimazole was administered.
Palpation: no abnormality.
Laboratory data: subclinical hyperthyroidism on daily 20 mg methimazole (TSH 0.05 mIU/L, FT4 20.9 pM/L).Â
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