Nontoxic Goiter Follow-up

Updated: Oct 05, 2021
  • Author: Stephanie L Lee, MD, PhD; Chief Editor: George T Griffing, MD  more...
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Follow-up

Further Outpatient Care

The patient with a large goiter and no obstructive symptoms can be monitored in an outpatient setting. Conduct a physical examination every 6 months to determine if obstructive symptoms have developed or worsened and to perform thyroid function tests (ie, TSH, free T4).

Depending on iodine intake in the diet, some of these patients develop thyroid autonomy and thyrotoxicosis.

Often, thyroid imaging is not necessary when the patient is examined by an endocrinologist experienced in thyroid examinations. The method of choice is ultrasonography unless the goiter extends into the thoracic inlet.

Routine nuclear scintigraphy is not necessary.

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Transfer

Transfer may be required in patients with significant tracheomalacia who require surgery. Long-term compression of the trachea by a nontoxic goiter causes tracheal cartilage to lose its strength. This can be life threatening, and tracheal intubation or tracheotomy may be required.

Additionally, if a goiter extends significantly into the thorax, a thoracic surgeon may be needed to open the chest wall to fully excise the goiter.

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