Serum thyroglobulin concentration in nontoxic goiter and response to surgery with special reference to risk of goiter relapse

Abstract A consecutive series of 45 thyroglobulin antibody‐negative patients were operated on for nontoxic goiter and subsequently followed systematically for 3 years. Preoperative mean log serum thyroglobulin was elevated with a significantly positive correlation to the size of removed goiter tissue. No thyroid replacement was given postsurgically. Following operation, the thyroglobulin level decreased significantly reaching a minimum at 1 year. Thereafter, there was a continuous rise. Free thyroxine index and serum thyrotropin showed changes corresponding to transient hypothyroidism 1 month after surgery, being gradually normalized within 1 year. At 3 years, a thyrotropinreleasing hormone (TRH) test showed the highest thyroidstimulating hormone (TSH) response in patients with elevated baseline thyroglobulin. Clinical investigation at 3 years, however, revealed no goiter relapse. Therefore, the predictive value of thyroglobulin with reference to recurrence of goiter could not be established as yet. The hypothetical assumption that patients who postoperatively present an elevated serum thyroglobulin level are more likely to develop recurrence compared to those with low thyroglobulin levels is discussed and will be tested further by a prolonged follow‐up period.