World Journal of Surgery

, Volume 31, Issue 3, pp 593–598 | Cite as

Recurrence after Total Thyroidectomy for Benign Multinodular Goiter

  • Kylie L. Snook
  • Peter L. H. Stalberg
  • Stan B. Sidhu
  • Mark S. Sywak
  • Pamela Edhouse
  • Leigh Delbridge



Total thyroidectomy is now the preferred option for the management of benign multinodular goiter (BMNG), and it ought not be associated with recurrent disease. The aim of the present study was to examine the efficacy of total thyroidectomy for BMNG and to review reasons for recurrence.

Material and methods

The study group comprised all patients from January 1980 to December 2005 who underwent a definitive procedure to remove all thyroid tissue for BMNG, and who were subsequently identified as having developed a recurrence. Included were patients who underwent primary total thyroidectomy at our unit, or a two or more stage procedure where a definitive secondary total thyroidectomy was performed at our unit.


There were 3,044 total or secondary total thyroidectomies performed for BMNG during the study period. Ten patients were identified as having developed recurrent BMNG requiring reoperation despite previous complete “total” thyroidectomy. There were 11 sites of recurrence in 10 patients. Only one was a true local recurrence in the thyroid bed. Another 9 recurrences related to the embryology of the thyroid gland, 4 in the pyramidal tract and 5 in the thyrothymic tract. There was one recurrence at another site (submandibular) in a patient with presumed metastatic thyroid cancer despite benign histology. There were no complications in any of the 10 patients.


Total thyroidectomy for BMNG is not only a safe procedure but is efficacious in preventing recurrent disease. Failure to remove embryological remnants such as thyrothymic residue or pyramidal remnants during total thyroidectomy is the major cause of recurrence.


Goiter Recurrent Laryngeal Nerve Total Thyroidectomy Thyroid Tissue Subtotal Thyroidectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Kylie L. Snook
    • 1
  • Peter L. H. Stalberg
    • 1
  • Stan B. Sidhu
    • 1
  • Mark S. Sywak
    • 1
  • Pamela Edhouse
    • 1
  • Leigh Delbridge
    • 1
  1. 1.Department of Endocrine and Oncology SurgeryUniversity of Sydney Endocrine Surgical Unit, Royal North Shore HospitalSydneyAustralia

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