Gross Total Thyroidectomy and Postop Radioactive Iodine Scan

When I do grossly total thyroidectomy on a patient with a thyroid cancer, when I do a postoperative radioactive iodine scan, there are usually foci of RAI uptake.  In the past, about 30 years ago, when I would run after the foci of postoperative RAI uptake, they would  usually not be palpable on reoperation.  I don’t know how to explain these focal RAI uptakes postoperatively after a grossly total thyroidectomy.

Literature has reports of 60% to 95% postoperative RAI uptake after a total thyroidectomy.


Thus, I have to tell my patients that when I do a total thyroidectomy, it will be “total” on all grossly visible thyroid gland.  That is all that I as a surgeon can do.  There may be an uptake on postoperative RAI scanning which may signify non-total thyroidectomy.  An informed consent has to be signed to avoid any misunderstanding.


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