Which of the following is NOT an indication for surgery in hyperthyroidism?

In the context of hyperthyroidism, surgery is typically indicated for cases where there are significant symptoms or complications that warrant intervention. One situation that does not typically require surgical intervention is subclinical hyperthyroidism. This condition is characterized by low serum thyroid-stimulating hormone (TSH) levels along with normal thyroid hormone levels (free T4 and T3), indicating that while there is mild thyroid overactivity, it does not yet produce the clinical symptoms associated with overt hyperthyroidism.

In contrast, pregnancy can complicate hyperthyroid management, but surgery may be considered if there are severe symptoms or significant risks to the mother or fetus. A large goiter causing compressive symptoms is another clear indication for surgery, as it can lead to difficulty breathing or swallowing. Similarly, an autonomously functioning thyroid nodule, particularly if it is producing excess hormones or leading to hyperthyroidism symptoms, may warrant surgical removal to alleviate these issues.

Thus, subclinical hyperthyroidism typically does not necessitate surgery unless there are other compelling factors or developments, which makes it the option that is not an indication for surgical intervention in the context of hyperthyroidism.