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.
- http://onlinelibrary.wiley.com/doi/10.1002/hed.2880140408/abstract (Varma – 60%)
- http://www.sciencedirect.com/science/article/pii/S1015958409602694 (95%)
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.