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Thyroid Diseases

Small, Friable Thyroid

02/03/2010

Question:

I had surgery to remove an adenoma on one of my parathyroid glands. The surgery became exploratory because the PTH levels did not go down. The surgeon ended up taking out the thyroid, which he says was "shriveled", tore easily, and was small and friable. There was no cancer.

I do not understand why the necessity of removing the total thyroid. I suspect he couldn`t find the rest of the parathyroid glands.

In your opinion, does a small, friable thyroid present any problems or dangers?

Thank you.

Answer:

Small thyroid not a problem if it is making enough thyroid hormone. The thyroid gland is often manipulated to see and remove parathyroid glands/adenomas.  Occasionally, a parathyroid gland can even be inside the thyroid.  It could be concievable that this manipulation led to thyroid bleeding which was only able to be controlled by removing the lobe.  This would be uncommon though and the details should be discussed with that surgeon. If the parathyroid level is still elevated, I would reccomend seeking a surgeon with expertise in parathyroid disease and difficult to find glands.   

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Response by:

Jeffrey J Sussman, MD Jeffrey J Sussman, MD
Associate Professor of Surgery, Chief, Division of Surgical Oncology
College of Medicine
University of Cincinnati