Multimedia
 | Media file 1: Intrathoracic goiter causing obstruction. This patient has a visible goiter on physical examination. In addition, he has distension of his left external jugular vein, facial erythema (when compared with his shoulder), and cutaneous varicosities of venous blood draining from his head into his chest because of jugular obstruction from his goiter. |
 | Media file 2: Technetium-99m (99mTc) thyroid scan of a large, nontoxic multinodular goiter. Multiple cold and hot nodules are observed in the enlarged thyroid gland. The white arrow indicates sternal notch marker. |
 | Media file 3: Areas of autonomy with excess thyroid hormone secretion in a large nodular goiter. This technetium-99m (99mTc) thyroid scan shows hot and cold nodules in a multinodular goiter. Although the patient's thyroid-stimulating hormone level had become progressively suppressed, it was within the reference range, at 0.4 mU/mL (reference range 0.35-5.5 mU/mL). |
 | Media file 4: Nontoxic goiter of the thyroid gland with tracheal compression. An axial, noncontrast computed tomography scan through the thyroid shows significant tracheal compression. |
 | Media file 5: Relief of tracheal compression after subtotal thyroidectomy of large, obstructive, nontoxic multinodular goiter. (A) Laryngoscopy demonstrating critical tracheal narrowing before thyroidectomy; (B) laryngoscopy showing widened patent trachea after thyroidectomy. |
 | Media file 6: Multinodular goiter. On visual inspection of the neck (image on left), this patient appears to have a goiter. The computed tomography scan (image on right) shows the asymmetrical goiter, measuring 9.3 x 7.4 cm, with tracheal deviation, although no tracheal obstruction is present. |
More on Goiter, Nontoxic |
| Overview: Goiter, Nontoxic |
| Differential Diagnoses & Workup: Goiter, Nontoxic |
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| Follow-up: Goiter, Nontoxic |
 Multimedia: Goiter, Nontoxic |
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References
Baloch ZW, LiVolsi VA. Fine-needle aspiration of the thyroid: today and tomorrow. Best Pract Res Clin Endocrinol Metab. Dec 2008;22(6):929-39. [Medline].
Agarwal G, Aggarwal V. Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? An evidence-based review. World J Surg. Jul 2008;32(7):1313-24. [Medline].
Weetman AP. Radioiodine treatment for benign thyroid diseases. Clin Endocrinol (Oxf). Jun 2007;66(6):757-64. [Medline].
Baczyk M, Pisarek M, Czepczynski R, Ziemnicka K, Gryczynska M, Pietz L, et al. Therapy of large multinodular goitre using repeated doses of radioiodine. Nucl Med Commun. Mar 2009;30(3):226-31. [Medline].
Duntas LH, Cooper DS. Review on the occasion of a decade of recombinant human TSH: prospects and novel uses. Thyroid. May 2008;18(5):509-16. [Medline].
Medeiros-Neto G, Marui S, Knobel M. An outline concerning the potential use of recombinant human thyrotropin for improving radioiodine therapy of multinodular goiter. Endocrine. Apr 2008;33(2):109-17. [Medline].
Braverman L, Kloos RT, Law B Jr, Kipnes M, Dionne M, Magner J. Evaluation of various doses of recombinant human thyrotropin in patients with multinodular goiters. Endocr Pract. Oct 2008;14(7):832-9. [Medline].
Phitayakorn R, McHenry CR. Follow-up after surgery for benign nodular thyroid disease: evidence-based approach. World J Surg. Jul 2008;32(7):1374-84. [Medline].
[Best Evidence] Worni M, Schudel HH, Seifert E, et al. Randomized controlled trial on single dose steroid before thyroidectomy for benign disease to improve postoperative nausea, pain, and vocal function. Ann Surg. Dec 2008;248(6):1060-6. [Medline].
Berghout A, Wiersinga WM, Drexhage HA, et al. Comparison of placebo with L-thyroxine alone or with carbimazole for treatment of sporadic non-toxic goitre. Lancet. Jul 28 1990;336(8709):193-7.
Bonnema SJ, Bertelsen H, Mortensen J, et al. The feasibility of high dose iodine 131 treatment as an alternative to surgery in patients with a very large goiter: effect on thyroid function and size and pulmonary function. J Clin Endocrinol Metab. Oct 1999;84(10):3636-41. [Medline]. [Full Text].
Braverman LE, Utiger RD, Hermus AR, Huysmans DA:. Clinical manifestations and treatment of nontoxic diffuse and nodular goiter. In: Werner & Ingbar's The Thyroid. Baltimore, Md: Lippincott Williams & Wilkins;. 2000;866-871.
Hegedus L, Gerber H. Multinodular goiter. In: DeGroot LJ, Jameson JL, eds. Endocrinology. 2001;2:1517-1528.
Hermus AR, Huysmans DA. Treatment of benign nodular thyroid disease. N Engl J Med. May 14 1998;338(20):1438-47. [Medline].
Hollowell JG, Staehling NW, Hannon WH, et al. Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys I and III (1971-1974 and 1988-1994). J Clin Endocrinol Metab. Oct 1998;83(10):3401-8. [Medline]. [Full Text].
Huysmans D, Hermus A, Edelbroek M, et al. Radioiodine for nontoxic multinodular goiter. Thyroid. Apr 1997;7(2):235-9. [Medline].
Huysmans DA, Hermus AR, Corstens FH, et al. Large, compressive goiters treated with radioiodine. Ann Intern Med. Nov 15 1994;121(10):757-62. [Medline].
Huysmans DA, Nieuwlaat WA, Erdtsieck RJ, et al. Administration of a single low dose of recombinant human thyrotropin significantly enhances thyroid radioiodide uptake in nontoxic nodular goiter. J Clin Endocrinol Metab. Oct 2000;85(10):3592-6. [Medline]. [Full Text].
Netterville JL, Coleman SC, Smith JC, et al. Management of substernal goiter. Laryngoscope. Nov 1998;108(11 Pt 1):1611-7. [Medline].
Perrild H, Hansen JM, Hegedus L. Triiodothyronine and thyroxine treatment of diffuse non-toxic goitre evaluated by ultrasonic scanning. Acta Endocrinol (Copenh). Jul 1982;100(3):382-7. [Medline].
Rios A, Rodriguez JM, Canteras M, et al. Surgical management of multinodular goiter with compression symptoms. Arch Surg. Jan 2005;140(1):49-53. [Medline]. [Full Text].
Ross DS. Thyroid hormone suppressive therapy of sporadic nontoxic goiter. Thyroid. Fall 1992;2(3):263-9. [Medline].
Further Reading
Related eMedicine topics:
Goiter
Goiter, Diffuse Toxic
Goiter, Lithium-Induced
Goiter, Toxic Nodular
Hypothyroidism [Endocrinology]
Hypothyroidism [Pediatrics: General Medicine]
Iodine Deficiency
Thyroid Nodules
Thyroid, Substernal Goiter
Clinical guidelines:
Management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi: medical guidelines for clinical practice for the diagnosis and management of thyroid nodules.
Clinical trials:
Levothyroxine Treatment in Thyroid Benign Nodular Goiter
rhTSH, Radioiodine Uptake and Goiter Reduction Following 131I Therapy in Patients With Benign Nontoxic Nodular Goiter
Keywords
nontoxic goiter, thyroid, goiter, TSH, hypothyroid, hypothyroidism, thyroid symptoms, thyroid disease, thyroid problems, thyroid hormone, thyroxine, thyroid levels, thyroid treatment, thyroid function, thyroid medication, TSH levels, TSH T4, enlarged thyroid, thyroid stimulating hormone, thyroid-stimulating hormone, thyroid hormones, thyroid TSH, T3 thyroid, multinodular goiter, triiodothyronine, thyroidectomy, iodine deficiency, adenomatous goiter, endemic goiter, sporadic goiter, nodular hyperplasia, follicular epithelial hyperplasia, cretinism,dyshormonogenesis, diffuse or nodular enlargement of the thyroid gland, diffuse goiter
