Ms. M. David, 55-year-old Filipina, consulted me in late 2016 for a second opinion. She was advised a thyroid operation by another surgeon. Her son, a medical student in the University of the Philippines College of Medicine, referred her to me.
When I saw the patient, my impression was a multiple colloid adenomatous goiter. I did a needle evaluation and aspiration biopsy and the latter showed consistent with colloid nodule. I advised M. David a trial of medical therapy. The biggest thyroid mass was 3 cm in size.
I started with a low dose of levothyroxine and then gradually increase it to a higher dose. In 6 months time, the masses decreased in size. I have been maintaining her on this medicine.
October 21, 2017 – she had a follow-up with me. The ultrasound result showed marked decrease in the sizes of the nodules. Clinically, there were no longer palpable thyroid nodules.
Note the October 2017 ultrasound was compared to the March 2016 ultrasound (prior to start of levothyroxine).
Note the decrease from 2.7 cm and 2.5 cm to subcentimeters (less than one centimeter) on ultrasound.
M. David is one of the hundreds of thyroid patients whom I have saved from unnecessary thyroid surgery since 1985 when I started doing needle evaluation and aspiration biopsy of thyroid nodules in my clinic.