Intervention Review

You have free access to this content

Levothyroxine or minimally invasive therapies for benign thyroid nodules

  1. Elizabeth Bandeira-Echtler*,
  2. Karla Bergerhoff,
  3. Bernd Richter

Editorial Group: Cochrane Metabolic and Endocrine Disorders Group

Published Online: 18 JUN 2014

Assessed as up-to-date: 11 APR 2014

DOI: 10.1002/14651858.CD004098.pub2


How to Cite

Bandeira-Echtler E, Bergerhoff K, Richter B. Levothyroxine or minimally invasive therapies for benign thyroid nodules. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD004098. DOI: 10.1002/14651858.CD004098.pub2.

Author Information

  1. Universitaetsklinikum Duesseldorf, Heinrich-Heine University, Institute of General Practice, Duesseldorf, Germany

*Elizabeth Bandeira-Echtler, Institute of General Practice, Universitaetsklinikum Duesseldorf, Heinrich-Heine University, Moorenstr. 5, Duesseldorf, 40225, Germany. bberio1@gmail.com. e.bandeira-echtler@uni-duesseldorf.de.

Publication History

  1. Publication Status: New
  2. Published Online: 18 JUN 2014

SEARCH

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
LP Dossing 2005 {published data only}
  • Dossing H, Bennedbaek FN, Hegedus L. Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules - a randomised study. European Journal of Endocrinology 2005;152(3):341-5.
LP Dossing 2006 {published data only}
  • Dossing H, Bennedbaek FN, Hegedus L. Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules: one versus three treatments. Thyroid 2006;16(8):763-8.
LP Dossing 2013 {published data only}
  • Dossing H, Bennedbaek FN, Hegedus L. Interstitial laser photocoagulation (ILP) of benign cystic thyroid nodules - a prospective randomized trial. The Journal of Clinical Endocrinology and Metabolism 2013;98(7):E1213-7.
LP Gambelunghe 2006 {published data only}
  • Gambelunghe G, Fatone C, Ranchelli A, Fanelli C, Lucidi P, Cavaliere A, et al. A randomized controlled trial to evaluate the efficacy of ultrasound-guided laser photocoagulation for treatment of benign thyroid nodules. Journal of Endocrinological Investigation 2006;29(9):RC23-6.
LP Papini 2007 {published data only}
  • Papini E, Guglielmi R, Bizzarri G, Graziano F, Bianchini A, Brufani C, et al. Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid 2007;17(3):229-35.
LT4 Bayani 2012 {published data only}
  • Bayani M, Amani M, Moazezi Z. Efficacy of levothyroxine on benign thyroid nodule. Caspian Journal of Internal Medicine 2012;3(1):359-62.
LT4 Boguszewski 1998 {published data only}
  • Boguszewski CL, Pedrazzani M, Graf H. Assessment of levothyroxine suppressive therapy in patients with solitary thyroid nodules: a double-blind, placebo-controlled, clinical trial. Arquivos Brasileiros de Endocrinologia e Metabologia 1998;42(3):214-21.
LT4 Cesareo 2010 {published data only}
LT4 Gharib 1987 {published data only}
  • Gharib H, James EM, Charboneau JW, Naessens JM, Offord KP, Gorman CA. Suppressive therapy with levothyroxine for solitary thyroid nodules. A double-blind controlled clinical study. The New England Journal of Medicine 1987;317(2):70-5.
LT4 Grineva 2003 {published data only}
  • Grineva EN, MalakhovaTV, Tsoi UA, Smirnov BI. Efficacy of thyroxine and potassium iodide in benign nodular lesions of the thyroid. Terapevticheskii Arkhiv 2003;75(8):72-5.
LT4 Grussendorf 2011 {published data only}
  • Grussendorf M, Reiners C, Paschke R, Wegscheider K, on behalf of the LISA investigators. Reduction of thyroid nodule volume by levothyroxine and iodine alone and in combination: a randomized, placebo-controlled trial. The Journal of Clinical Endocrinology and Metabolism 2011;96:2786-95. [DOI: 10.1210/jc.2011-0356]
LT4 Koc 2002 {published data only}
LT4 Larijani 2005 {published data only}
  • Larijani B, Pajouhi M, Bastanhagh MH, Sadjadi A, Aghakhani S, Zare F, et al. Role of levothyroxine suppressive therapy for benign cold nodules of thyroid: a randomized, double-blind, placebo-controlled clinical trial. Therapy 2005;2(6):883-8.
  • Larijani B, Pajouhi M, Bastanhagh MH, Sadjadi A, Sedighi N, Eshraghian MR. Evaluation of suppressive therapy for cold thyroid nodules with levothyroxine: double-blind placebo-controlled clinical trial. Endocrine Practice 1999;5(5):251-6.
LT4 La Rosa 1995 {published data only}
  • La Rosa GL, Lupo L, Giuffrida D, Gullo D, Vigneri R, Belfiore A. Levothyroxine and potassium iodide are both effective in treating benign solitary solid cold nodules of the thyroid. Annals of Internal Medicine 1995;122(1):1-8.
LT4 Ozkaya 2010 {published data only}
  • Ozkaya EC, Aydin Y, Ozkan B, Karaahmetoglu OS, Eskioglu E, Guler S. The effect of thyroxine-suppressive therapy in patients with euthyroid nodular disease: A randomized controlled study. Endocrinologist 2010;20(4):182-4.
LT4 Papini 1993 {published data only}
LT4 Papini 1998 {published data only}
  • Papini E, Petrucci L, Guglielmi R, Panunzi C, Rinaldi R, Bacci V, et al. Long-term changes in nodular goiter: a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules. The Journal of Clinical Endocrinology and Metabolism 1998;83(3):780-3.
LT4 Reverter 1992 {published data only}
LT4 Tsai 2006 {published data only}
LT4 Wemeau 2002 {published data only}
  • Wemeau JL, Caron P, Schvartz C, Schlienger JL, Orgiazzi J, Cousty C, et al. Effects of thyroid-stimulating hormone suppression with levothyroxine in reducing the volume of solitary thyroid nodules and improving extranodular nonpalpable changes: a randomized, double-blind, placebo-controlled trial by the French Thyroid Research Group. The Journal of Clinical Endocrinology and Metabolism 2002;87(11):4928-34.
  • Wemeau JL, Cousty C, Vlaeminck V. Suppressive hormone therapy for thyroid nodules. Prospective evaluation. Preliminary results [Hormonotherapie freinatrice pour nodule thyroidien. Evaluation prospective. Resultats preliminaires]. Annales d'Endocrinologie 2000;61(2):119-24.
LT4 Zelmanovitz 1998 {published data only}
  • Zelmanovitz F, Genro S, Gross JL. Suppressive therapy with levothyroxine for solitary thyroid nodules: a double-blind controlled clinical study and cumulative meta-analyses. The Journal of Clinical Endocrinology and Metabolism 1998;83(11):3881-5.
PEI Bennedbaek 1998 {published data only}
  • Bennedbaek FN, Nielsen LK, Hegedus L. Effect of percutaneous ethanol injection therapy versus suppressive doses of L-thyroxine on benign solitary solid cold thyroid nodules: a randomized trial. The Journal of Clinical Endocrinology and Metabolism 1998;83(3):830-5.
PEI Bennedbaek 1999 {published data only}
  • Bennedbaek FN, Hegedus L. Percutaneous ethanol injection therapy in benign solitary solid cold thyroid nodules: a randomized trial comparing one injection with three injections. Thyroid 1999;9(3):225-33.
PEI Bennedbaek 2003 {published data only}
  • Bennedbaek FN, Hegedus L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. The Journal of Clinical Endocrinology and Metabolism 2003;88(12):5773-7.
PEI Chu 2003 {published data only}
  • Chu CH, Chuang MJ, Wang MC, Lam HC, Lu CC, Lee JK. Sclerotherapy of thyroid cystic nodules. Journal of the Formosan Medical Association 2003;102(9):625-30.
PEI Sung 2013 {published data only}
  • Sung JY, Baek JH, Kim KS, Lee D, Yoo H, Kim JK, et al. Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study. Radiology 2013;259(1):293-300. [10.1148/radiol. 13122134]
PEI Valcavi 2004 {published data only}
  • Valcavi R, Frasoldati A. Ultrasound-guided percutaneous ethanol injection therapy in thyroid cystic nodules. Endocrine Practice 2004;10(3):269-75.
PEI Verde 1994 {published data only}
RF Faggiano 2012 {published data only}
RF Huh 2012 {published data only}
  • Huh JY, Baek JH, Choi H, Kim JK, Lee JH. Symptomatic benign thyroid nodules: efficacy of additional radiofrequency ablation treatment session - prospective randomized study. Radiology 2012; Vol. 263, issue 3:909.
TETRA Hegedüs 1988 {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Baek 2010 {published data only}
  • Baek JH, Kim YS, Lee D, Huh JY, Lee JH. Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. American Journal of Roentgenology 2010;194(4):1137-42.
Cheung 1989 {published data only}
Diacinti 1992 {published data only}
  • Diacinti D, Salabe GB, Olivieri A, D'Erasmo E, Tomei E, Lotz-Salabe H, et al. Efficacy of L-thyroxine (L-T4) therapy on the volume of the thyroid gland and nodules in patients with euthyroid nodular goiter (ENG). [Italian] [Efficacia della terapia con L-tiroxina (L-T4) sul volume della tiroide e dei noduli in pazienti con gozzo nodulare eutiroideo (GNE)]. Minerva Medica 1992;83(11):745-51.
Dossing 2002 {published data only}
  • Dossing H, Bennedbaek FN, Karstrup S, Hegedus L. Benign solitary solid cold thyroid nodules: US-guided interstitial laser photocoagulation-initial experience. Radiology 2002;225(1):53-7.
Erdem 1997 {published data only}
  • Erdem E, Bostanci B, Ozden A, Sungurtekin U, Nessar M. The effectiveness of levothyroxine suppressive therapy in patients with multinodular goiter [Multinoduler guatrli hastalarda levotiroksinle supresyon tedavisinin etkinligi]. Turkish Journal of Surgery 1997;13(6):400-4.
Kanotra 2008 {published data only}
  • Kanotra S.P, Lateef M, Kirmani O. Non-surgical management of benign thyroid cysts: use of ultrasound-guided ethanol ablation. Postgraduate Medical Journal 2008;84(998):639-43.
Kim 2005 {published data only}
  • Kim DW, Rho MH, Kim HJ, Kwon JS, Sung YS, Lee SW. Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous?. American Journal of Neuroradiology 2005;26(8):2122-7.
Knight 2006 {published data only}
Lima 1997 {published data only}
  • Lima N, Knobel M, Cavaliere H, Sztejnsznajd C, Tomimori E, Medeiros-Neto G. Levothyroxine suppressive therapy is partially effective in treating patients with benign, solid thyroid nodules and multinodular goiters. Thyroid 1997;7(5):691-7.
Mainini 1995 {published data only}

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
LP Dossing 2001 {published data only}
  • NCT00150150. Ultrasound guided interstitial laser photocoagulation on benign thyroid nodules. http://clinicaltrials.gov/ct2/show/NCT00150150 (accessed 29 July 2013).
LP Pacella 2008 {published data only}
  • NCT00858104. Multicentric randomized controlled study of percutaneous laser ablation versus follow up in benign thyroid nodules. Long term results. http://clinicaltrials.gov/ct2/show/NCT00858104 (accessed 29 July 2013).
LT4 Shih 2007 {published data only}
  • NCT00552253. Levothyroxine treatment in thyroid benign nodular goiter. http://clinicaltrials.gov/ct2/show/NCT00552253 (accessed 29 July 2013).
RF Baek 2013 {published data only}
  • NCT01778400. Single session treatment of RFA versus EA for predominantly cystic thyroid nodules: a randomized controlled trial. clinicaltrials.gov/ct2/show/NCT01778400 (accessed 29 July 2013).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
AACE/AME/ETA Guidelines 2010
  • Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association: medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocrine Practice 2010;16 Suppl 1:1-43.
Alcantara-Jones 2006
  • Alcantara-Jones DM, Araujo LM, Almeida MA, Jones DA, Cardoso LJG, Passos MC. Percutaneous ethanol injection for the treatment of thyroid nodules [Efeito da injecao percutânea de etanol na reducao de nódulos tireoideanos]. Arquivos Brasileiros de Endocrinologia & Metabologia 2006;50(1):97-104.
Alexander 2003
Astwood 1960
ATA 2009
  • American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214.
Baek 2009
Bauer 2001
Belfiore 1992
Bennedbaek 1995
Bennedbaek 1997
Biondi 1993
  • Biondi B, Fazio S, Carella C, Amato G, Cittadini A, Lupoli G, et al. Cardiac effects of long term thyrotropin-suppressive therapy with levothyroxine. The Journal of Clinical Endocrinology and Metabolism 1993;77(2):334-8.
Braga-Brasaria 2002
  • Braga-Basaria M, Trippia MA, Stolf AR, Mesa CJr, Graf H. Treatment of autonomous and cystic thyroid nodules with intranodular ethanol injection [Tratamento de nódulos autônomos e císticos da tireóide com injecao intranodular de etanol]. Revista da Associacao Médica Brasileira 2002;48(4):335-40.
Brander 1991
Brito 2013
  • Brito JP, Yarur AJ, Prokop LJ, McIver B, Murad MH, Montori VM. Prevalence of thyroid cancer in multinodular goiter versus single nodule: a systematic review and meta-analysis. Thyroid 2013;23(4):449-55.
Burch 1995
Castro 2002
  • Castro MR, Caraballo PJ, Morris JC. Effectiveness of thyroid hormone suppressive therapy in benign solitary thyroid nodules: a meta-analysis. The Journal of Clinical Endocrinology and Metabolism 2002;87(9):4154-9.
Cooper 1995
  • Cooper DS. Clinical review 66: thyroxine suppression therapy for benign nodular disease. The Journal of Clinical Endocrinology and Metabolism 1995;80(2):331-4.
Daniels 1996
  • Daniels GH. Thyroid nodules and nodular thyroids: a clinical overview. Comprehensive Therapy 1996;22:239-50.
Davies 2006
Deandrea 2008
  • Deandrea M, Limone P, Basso E, Mormile A, Ragazzoni F, Gamarra E, et al. US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound in Medicine & Biology 2008;34(5):784-91.
Dossing 2007
  • Dossing H, Bennedbaek FN, Bonnema SJ, Grupe P, Hegedus L. Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules. European Journal of Endocrinology 2007;157(1):95-100.
Dossing 2011
Esnault 2008
  • Esnault O, Leenhardt L. High intensity focused ultrasound (HIFU) ablation therapy for thyroid nodules. In: Baskin HJ, Duick DS, Levine RA editor(s). Thyroid ultrasound and ultrasound-guided FNA. 2nd Edition. New York: Springer, 2008:219-36.
Esnault 2011
  • Esnault O, Franc B, Ménégaux F, Rouxel A, De Kerviler E, Bourrier P, et al. High-Intensity focused ultrasound ablation of thyroid nodules: first human feasibility study. Thyroid 2011;21(9):965-73.
Feng 2012
  • Feng B, Liang P, Cheng Z, Yu X, Yu J, Han Z, et al. Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. European Journal of Endocrinology / European Federation of Endocrine Societies 2012; Vol. 166, issue 6:1031-7. [1479-683X: (Electronic)]
Filetti 2006
Fuller 2014
Galofré 2008
Gharib 1998
Gharib 2007
Gharib 2010
  • Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Journal of Endocrinological Investigation 2010; Vol. 33, issue Suppl:51-6.
Gharib 2013
  • Gharib H, Hegedus L, Pacella CM, Baek JH, Papini E. Clinical review: nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. The Journal of Clinical Endocrinology and Metabolism 2013; Vol. 98, issue 10:3949-57. [1945-7197: (Electronic)]
Hamming 1990
  • Hamming JF, Goslings BM, Van Steenis GJ, van Ravenswaay Claasen H, Hermans J, et al. The value of fine needle aspiration biopsy in patients with nodular thyroid disease divided into groups of suspicion of malignant neoplasms on clinical grounds. Archives of Internal Medicine 1990;150(1):113-6.
Higgins 2002
Higgins 2003
Higgins 2009
Higgins 2011a
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Higgins 2011b
Hrobjartsson 2012
  • Hrobjartsson A, Thomsen AS, Emanuelsson F, Tendal B, Hilden J, Boutron I, et al. Observer bias in randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non-blinded outcome assessors. BMJ 2012;344:e1119. [PUBMED: 22371859]
Hrobjartsson 2013
  • Hrobjartsson A, Thomsen AS, Emanuelsson F, Tendal B, Hilden J, Boutron I, et al. Observer bias in randomized clinical trials with measurement scale outcomes: a systematic review of trials with both blinded and nonblinded assessors. Canadian Medical Association Journal 2013;185(4):E201-11. [PUBMED: 23359047]
Huang 2013
Jemal 2009
Jeong 2008
  • Jeong WK, Baek JR, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. European Radiology 2008;18(6):1244-50.
Kaplan 1990
Kim 2006
Kuma 1992
LATS 2009
  • Camargo R, Corigliano S, Friguglietti C, Gauna A, Harach R, Munizaga F, et al. Latin American thyroid society recommendations for the management of thyroid nodules [Recomendacoes da Sociedade Latino-Americana de Tireoide no manejo de nódulos tireoideos]. Arquivos Brasileiros de Endocrinologia e Metabologia 2009;53(9):1167-75.
Leese 2011
Liberati 2009
  • Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic and meta-analyses of studies that evaluate interventions: explanation and elaboration. PLoS Med 1999;6(7):1-28. [DOI: 10.1371/journal.pmed.1000100]
Lima 2007
  • Lima MA, Fagundes TA, Raffaelli CM, Ferreira BP, Resende EM, Fonseca EC, et al. Alcoholization in the treatment of thyroid nodule in colloid goiter endemic region [Alcoolizacao de nódulo tiroidiano em regiao endêmica de bócio colóide]. Arquivos Brasileiros de Endocrinologia e Metabologia 2007;51(6):1007-12.
Livraghi 1990
  • Livraghi T, Paracchi A, Ferrari C, Bergonzi M, Garavaglia G, Raineri P, et al. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Work in progress. Radiology 1990;175(3):827-9.
Mazzaferri 1988
  • Mazzaferri EL, de los Santos ET, Rofaghan-Keyhani S. Solitary thyroid nodule: diagnosis and management. Medical Clinics of North America 1988;72(5):1177-211.
Mazzaferri 1993
McCall 1986
  • McCall A, Jarosz H, Lawrence AM, Paloyan E. The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goiters. Surgery 1986;100(6):1128-32.
Morita 1989
  • Morita T, Tamai H, Oshima A, Komaki G, Matsubayashi S, Kuma K, et al. Changes in serum thyroid hormone, thyrotropin and thyroglobulin concentrations during thyroxine therapy in patients with solitary thyroid nodules. The Journal of Clinical Endocrinology and Metabolism 1989;69(2):227-30.
Pacella 2000
  • Pacella CM, Bizzarri G, Guglielmi R, Anelli V, Bianchini A, Crescenzi A, et al. Thyroid tissue: US-guided percutaneous interstitial laser ablation - a feasibility study. Radiology 2000;217(3):673-7.
Papini 1993
Papini 1995
Papini 2004
  • Papini E, Guglielmi R, Bizzarri G, Pacella CM. Ultrasound-guided laser thermal ablation for treatment of benign thyroid nodules. Endocrine Practice 2004;10(3):276-83.
Pelizzo 1990
  • Pelizzo MR, Piotto A, Rubello D, Casara D, Fassina A, Busnardo B. High prevalence of occult papillary thyroid carcinoma in a surgical series for benign thyroid disease. Tumori 1990;76(3):255-7.
Richter 2002
Sdano 2005
  • Sdano MT, Falciglia M, Welge JA, Steward DL. Efficacy of thyroid hormone suppression for benign thyroid nodules: meta-analysis of randomized trials. Otolaryngology - Head and Neck Surgery 2005;133(3):391-6.
Spiezia 2009
  • Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 2009;19(3):219-25.
Stall 1990
Stern 2011
  • Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011;343:d4002.
Tunbridge 1977
Uzzan 1996
  • Uzzan B, Campos J, Cucherat M, Nony P, Boissel JP, Perret GY. Effects on bone mass of long term treatment with thyroid hormones: a meta-analysis. The Journal of Clinical Endocrinology & Metabolism 1996;81(12):4278-89.
Vander 1968
  • Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study on the incidence of thyroid malignancy. Annals of Internal Medicine 1968;69(3):537-40.
Wood 2008
  • Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 2008;336(7644):601-5.
Yousef 2010
  • Yousef A, Clark J, Suhail AR. Thyroxine suppression therapy for benign, non-functioning solitary thyroid nodules: a quality-effects meta-analysis. Clinical Medicine and Research 2010;8(3-4):150-8.
Zelmanovitz 1998
  • Zelmanovitz F, Genro S, Gross JL. Suppressive therapy with levothyroxine for solitary thyroid nodules: a double-blind controlled clinical study and cumulative meta-analyses. The Journal of Clinical Endocrinology and Metabolism 1998;83(11):3881-5.
Zingrillo 1998
  • Zingrillo M, Collura D, Ghiggi MR, Nirchio V, Trischitta V. Treatment of large cold benign thyroid nodules not eligible for surgery with percutaneous ethanol injection. The Journal of Clinical Endocrinology and Metabolism 1998;83(11):3905-7.