Multinodular goitre: a common asymptomatic disease

Written by: Dr. Francisco García Lorenzo
Edited by: Top Doctors®

Goiter is an enlarged thyroid gland in the front of the neck, butterfly-shaped and supported on the trachea. This growth can be uniform, diffuse goiter, or associated with the occurrence of one or more nodules, nodular or multinodular goiter.


The multinodular goiter is a very common condition, caused by different reasons: deficit in the supply of iodine intake goitrogens (such as cauliflower, Brussels sprouts, nuts, etc.), drugs (such as perchlorates, colchicine, thiocyanate) birth defects and autoimmune phenomena.


Symptoms of multinodular goitre

In its early stages, multinodular goiter is usually asymptomatic, but the progressive growth of nodules ago with symptoms of compression: dysphagia occurs when performed on the esophagus; dyspnea on the trachea; dysphonia, compression of the recurrent laryngeal nerves, acting on the vocal cords. In most cases they retain thyroid function, but in advanced stages there may be alteration thereof with the onset of hypothyroidism or hyperthyroidism.


Diagnosis of multinodular goitre

Given their limited clinical study, diagnosis is usually accidental, following a neck exploration or performing a cervical ultrasound for other reasons.

The diagnostic test is the quintessential cervical ultrasound, which describes the number, size, appearance and characteristics of thyroid nodules and the presence of associated cervical lymphadenopathy, which would suspect malignancy. Other tests used in the study of goiter include: scintigraphy, CT or MRI.

The method of Fine needle aspiration (FNA) allows to know the nature of the nodule. It is recommended be performed under ultrasound guidance, allowing the most suspicious nodule puncture. Recall that the multinodular goiter is associated by 5% to thyroid cancer.


Multinodular goitre treatment

The definitive treatment in general surgery for multinodular goiter surgical treatment, but not all require surgery multinodular goiters. The indications are suspected malignancy, compressive symptoms, endotorácico growth, functional impairment or childhood.

The surgical technique is to make total thyroidectomy, in which the entire thyroid gland is removed and therefore the disease. It is a delicate surgery by the existence of structures vital to the voice, laryngeal, or nerves calcium metabolism, parathyroid, which must be respected. It is therefore recommended that the surgery be performed by experts in the field. This surgery involves the need for replacement therapy for life, but the patient generally well tolerated.

*Translated with Google translator. We apologize for any imperfection
Dr. Francisco García Lorenzo

By Dr. Francisco García Lorenzo

Renowned specialist in General and Digestive Surgery, Dr. Lorenzo Garcia has extensive experience of over 20 years, focusing his career in Endocrine Surgery since 2010. Degree in Medicine and Surgery from the Faculty of Medicine of the University of Santiago de Compostela in 1992, in 2003 completed specialization in General Surgery and Digestive Diseases. Throughout his career he has spread his knowledge being taught at various conferences and meetings and made numerous presentations at national and international level. Author and coauthor of numerous publications related to their specialty. Current General Surgeon in General Surgery and Gastroenterology, University Hospital Complex of Vigo (CHUVI).

*Translated with Google translator. We apologize for any imperfection

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