Use este identificador para citar o ir al link de este elemento: http://hdl.handle.net/1843/61410
Tipo: Artigo de Periódico
Título: Compressive non-toxic intrathoracic goiter in patient with contraindication to surgical treatment: case report
Autor(es): Gustavo Cancela e Penna
Rachel Cardoso Lopes Rego
Gabriela Malta Silva Diniz
Gabriela Maciel Campolina Cardoso
Rudolf Moreira Pfeilsticker
Adelina Sanches
Barbara Moreira Ribeiro Trindade dos Santos
Hans Graf
Resumen: Introduction: Thyroidectomy is the treatment of choice for non-toxic compressive Multinodular Goiter (MNG). However, when surgery is contraindicated, other therapeutic options should be evaluated. In this case report, non-surgical therapeutic possibilities are reviewed, and the results obtained with Radioiodine Therapy (RAI) after stimulating with Recombinant Thyroid-Stimulating Hormone (rhTSH) are described. Case report: A 92-year-old patient with multiple comorbidities, non-toxic MNG, and symptomatic compression of the trachea and esophagus. Accordingly, RAI was chosen due to the high surgical risk. Initially, pre-treatment with methimazole was performed to increase TSH, which was interrupted due to drug hepatitis. Then, RAI was chosen in the post-stimulus with a low dose of rhTSH, with significant and early reduction of goiter and symptoms. Discussion: Although total thyroidectomy is the treatment of choice for non-toxic and symptomatic intrathoracic MNG; it does present risks, especially in patients with multiple comorbidities. Thus, interest in less invasive techniques is increasing. Thermal radio-ablations exhibit satisfactory results, however it is still an inaccessible technique. Radioiodine is an effective treatment option subsequent to the use of rhTSH or hypothyroidism methimazole-induced. RhTSH and methimazole can increase the level of radiation absorbed by the gland, which can lead to a reduction in the required I-131 dose. Conclusion: It is possible to mitigate the symptoms and improve the quality of life of patients with non-toxic and symptomatic MNG and multiple comorbidities, without surgical intervention. In this case report we describe alternatives to surgical intervention and show the effectiveness and safety of RAI along with rhTSH in the management of MNG.
Asunto: Bócio
Nódulo da glândula tireoide
Tireoidectomia
Idioma: eng
País: Brasil
Editor: Universidade Federal de Minas Gerais
Sigla da Institución: UFMG
Departamento: MED - DEPARTAMENTO DE CLÍNICA MÉDICA
Tipo de acceso: Acesso Aberto
Identificador DOI: http://dx.doi.org/10.37871/jbres1429
URI: http://hdl.handle.net/1843/61410
Fecha del documento: 2022
metadata.dc.url.externa: https://www.jelsciences.com/articles/jbres1429.php
metadata.dc.relation.ispartof: Journal of Biomedical Research and Environmental Sciences
Aparece en las colecciones:Artigo de Periódico

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