This protocol addresses thyroid adenoma arising in the setting of benign multinodular goiter with a normal (normo-functioning) serum TSH. When nodules are symptomatic and confirmed benign in this context, a specific management pathway applies that differs from hyperfunctioning or malignant nodule presentations.
Radioactive iodine (RAI) is the primary intervention considered in eligible patients with this presentation, with surgery available as an alternative in select cases. The protocol specifies which modality to apply and under what conditions — the full criteria, preparatory considerations, and decision points are detailed in the structured regimen.
The primary clinical target is a substantial reduction in thyroid volume within 12 months, with accompanying relief of compressive or pressure symptoms.
DOI: 10.1530/ETJ-23-0067
Consider RAI as an alternative to surgery in benign normo-functioning multinodular goiter.
When symptomatic and benign, thyroid nodules may, as an alternative to surgery, be eligible for RAI, especially in case of patients at surgical risk.
Most patients are offered fixed activity RAI, dependent on local regulations.
Thyroid volume is typically reduced by 40% within 12 months and alleviates symptoms in most.
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