Endocrine Abstracts

Objective: To investigate the results of J – 131 treatments in patients (pts) with autonomous thyroid adenomas in long period of follow up.

Material and Methods: We enrolled 68 consecutive pts with Plummer’s disease (50 females, 18 males, mean age 54,7 yrs, range 21 – 79 yrs) for period 2000 – 2020 yrs. 87%(59/68) pts had a unifocal nodule, while 13% (9/68) pts had multifocal toxic autonomous nodules. Pts stopped antithyroid drugs for at least one month prior to the radioiodine therapy and than we administered a J- 131 activity of 740 -+180 MBq (range 550 – 1150 MBq), based of size and weight of ‘hot’ nodules and the value of radiiodine uptake. Volumetry was done by ultrasound. The mean duration of follow up was 7,84 yrs.

Results: In 65/68 (95%) pts was administered a single dose, while 3/68(5%) pts needed two doses. 62/68 (91,3%) pts who received a single dose were euthyroid with scintigraphic normalization. The percentage of euthyroid did not significantly change in long term of 20 yrs observation. The recurrent hyperthyroidism was 2,9% (2/68) pts. The cumulative incidence of hypothyroidism was 11,8% (8/68) pts withing 1 – 6,2 yrs. The nodular volume was statistically higher in pts who had recurrent hyperthyroidism over hypothyroidism (P<0,01) and euthyroidism (P<0,02). The development of hypothyroidism was higher in pts who showed extranodular uptake and after TSH suppression. No differences were observed in the results between unifocal and multifocal nodules.

Conclusions: J – 131 therapy is a simple, safe and 97% effective treatment of autonomous functioning thyroid adenoma after one or more radioiodine doses.