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 R. Abendan a trial of medical therapy. The biggest thyroid mass was 4 cm in size.
I started with a low dose of levothyroxine and then gradually increase it to a higher dose. In one month’s time (March 2017), the 4-cm mass shrunk to 1-2 cm. I have been maintaining her on this medicine.
On October 2017 – she had a follow-up with me. Clinically, there was only about 1-cm palpable nodule on the right side. I am maintaining her on the levothyroxine.
The ultrasound done in June 2017 showed marked decrease in the sizes of the nodules from the largest of 4 cm to subcentimeters (less than one centimeter) on ultrasound.
Note the comparison of the June 2017 ultrasound to the Deceomber 2016 ultrasound (prior to start of levothyroxine).
Note the decrease from 4 cm to subcentimeter (less than one centimeter) on ultrasound.
December 2016 ultrasound result:
June 2017 ultrasound result:
R. Abendan 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.