Goitre

A goiter (GOI-tur) is the irregular growth of the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of the neck just below the Adam's apple.

A goiter may be an overall enlargement of the thyroid, or it may be the result of irregular cell growth that forms one or more lumps (nodules) in the thyroid. A goiter may be associated with no change in thyroid function or with an increase or decrease in thyroid hormones.

Characteristic features

• Common in regions with low - iodine diets.
• High rate of congenital hypothyroidism and cretinism.
• Goiters may become multinodular and enlarge.
• Most adults with endemic goiter are euthyroid; however, some are hypothyroid or hyperthyroid.

Management

• Small euthyroid goiters do not require treatment.
• Advice use of iodized salts in mountainous (iodine deficient) areas
• Treat associated hypothyroidism / hyperthyroidism
• Give symptomatic therapy
• Perform sub - total thyroidectomy where indicated (in case of obstructive symptoms like dysphagia, dyspnea etc.).
• Better to refer the patient to Endocrinologist or surgeon where complications or malignancy is suspected.