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Thyroid Gland Enlargement (Goiter)

Goiter is a treatable condition caused by thyroid gland dysfunction. If detected early, it can be managed effectively, but neglect may lead to cancer. Goiter, an enlargement of the thyroid gland located in the neck, disrupts thyroid function, impacting hormone secretion. Normal thyroid function is termed “euthyroidism,” while excessive hormone secretion is “hyperthyroidism,” and insufficient hormone production is “hypothyroidism.”

Symptoms of Hyperthyroidism include nervousness, weight loss with increased appetite, excessive sweating, tremors, muscle weakness, frequent bowel movements, urination, menstrual irregularities, and potential eye protrusion. Symptoms of Hypothyroidism are weakness, rapid fatigue, slowed movements and heart rate, drowsiness, cold intolerance, hoarseness, hair loss, constipation, and menstrual cessation in women.

Goiter types are classified as:

  • Diffuse Hyperplasia: Growth without nodules, often due to iodine deficiency.
  • Nodular Goiter: Presence of nodules within the thyroid gland, varying in size.

Symptoms of goiter might be minimal if hormone levels are normal, mainly presenting as a visible swelling in the neck. Larger goiters may cause breathing difficulties or hoarseness and might extend into the chest cavity.

Diagnosis involves physical examination, thyroid ultrasound, blood tests, and possibly thyroid scintigraphy. An aspiration biopsy may also be needed. Treatment varies from medication to surgery, depending on the goiter type and symptoms.

Surgery is considered for large, symptomatic goiters, suspected cancer, or cosmetic reasons. Pre-surgery, thyroid hormone levels must be normalized to avoid complications. Surgery involves a 4-5 cm incision in the neck, with procedures ranging from partial to total thyroidectomy. Risks include hoarseness or loss of voice, typically due to swelling or surgical impact on vocal cord nerves, though these usually resolve over time.

Published: 19.06.2023
Author: Cavit Hamzaoglu M.D
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