Goiter

Any enlargement of the thyroid gland

Classification on the basis of

• Location (cervical vs. substernal)

• Morphology (diffuse vs. nodular)

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

Neck swelling, patient or physician noted

Usually asymptomatic

Pain (thyroiditis)

Incidental finding on imaging, especially with substernal goiter

Occasional obstructive symptoms

• Dysphagia...

Hypothyroid—L-thyroxine

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

Ultrasound annually for nodular goiter

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

E04.9 Nontoxic goiter, unspecified

E04.2 Nontoxic multinodular goiter

E05.00 Thyrotoxicosis w diffuse goiter w/o thyrotoxic crisis

E03.0 Congenital hypothyroidism with diffuse goiter

E04.1 Nont...

TSH is best initial screening test for both hypothyroidism and hyperthyroidism.

Any nodule with suspicious features by history, exam, or ultrasound should be biopsied.

Treatment of goite...