Non-toxic Goiter1

Question 1

What does goiter mean?

Answer 1

Any enlargement of the thyroid gland

Question 2

What are some causes of goiter?

Answer 2

Toxic multinodular goiter, Graves disease, thyroiditis, or cancer; worldwide, it is most often associated with a nontoxic (colloid or nodular) goiter

Question 3

What is the most common cause of goiter worldwide?

Answer 3

ﾠIodine deficiency

Question 4

What is the pathogenesis of nontoxic goiter?

Answer 4

Multifactorial, including iodine deficiency, goitrogens (bamboo shoots, maize, and sweet potatoes), genetic factors, dyshormonogenesis, and excess circulating growth factors such as TSH and insulin-like growth factor (IGF).

Question 5

If symptomatic, nontoxic goiters can caused?

Answer 5

Compressive symptoms such as dyspnea or dysphagia as well as change in voice from the effects of pressure on the recurrent laryngeal nerve or larynx from large nodules or from sudden hemorrhage into a preexisting nodule.

Question 6

Which patients with non-toxic goiter will require treatment?

Answer 6

Patients with local discomfort, such as tightness or a choking sensation, or mechanical obstruction of the upper aerodigestive tree. Goiters have an annual growth rate on average of about 20%.

Question 7

What is the best treatment for symptomatic non-toxic goiters?

Answer 7

Near-total or total thyroidectomy