Skip to main content

Goiter

Rudolph M. Krafft, FAAFP, MD and Jessica L. Handel, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Enlargement of the thyroid gland

  • Classification on the basis of

    • Location (cervical vs. substernal)

    • Morphology (diffuse vs. nodular)

    • Functional status (hypothyroid, euthyroid, or hyperthy...

DIAGNOSIS

HISTORY

  • Neck swelling, patient or physician noted

  • Usually asymptomatic

  • Pain (thyroiditis)

  • Incidental finding on imaging, especially with substernal goiter

  • Occasional obstructive symptoms

    • Dysphagia...

TREATMENT

MEDICATION

First Line

  • Hypothyroid—L-thyroxine

  • Hyperthyroid—iodine-131 (I-131), antithyroid drugs, and surgery all considered reasonable options. The choice of therapy depends on symptoms, size ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Ultrasound annually for nodular goiter

  • TSH annually for euthyroid goiters to detect development of hypothyroidism in thyroiditis or hyperthyroidi...

REFERENCES

1
Kahaly G. Management of Graves thyroidal and extrathyroidal disease: an update. J Clin Endocrinol Metab. 2020;105(12):3704–3720.
2
Azizi F, Amouzegar A, Tohidi M, et al. Increased remission ...

CODES

ICD10

  • E01.0 Iodine-deficiency related diffuse (endemic) goiter

  • E04 Other nontoxic goiter

  • E05.2 Thyrotoxicosis with toxic multinodular goiter

  • E04.8 Other specified nontoxic goiter

  • E05.01 Thyrotoxicosi...

CLINICAL PEARLS

  • Treatment of goiter should be based on the risk of malignancy, the function of the gland, and compressive symptoms. Patient preference should also be taken into account, particularly w...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×