How to treat multinodular goiter

Written by: Dr. Ramón Díaz Conradi
Edited by: Anna Raventós Rodríguez

The multinodular goiter is irregular enlargement of the thyroid gland at the expense of the gland itself and the presence of several nodules. It's more common in women.

When more than 10% of the population suffers from a multinodular goiter, it can be classified as endemic. The best-known endemic areas are located in high mountain regions; The most important factor of its appearance is the iodine deficiency in its diet (although it is also endemic goiter due to iodine excess).

The areas with the most deficits are those that are subject to heavy rains.


Symptoms of multinodular goiter

  • Compressive syndrome ; When the goiter grows towards the thorax, being able to give respiratory or digestive problems, as well as dysphonia.
  • Hyperthyroidism ; In 10% of the cases the goiter presents an excessive production of thyroid hormone. It is necessary to establish medical treatment with antithyroid drugs to control the function of the thyroid gland.
  • Asymptomatic ; Is the most frequent. It manifests as a tumor in the anterior cervical level that is displaced by swallowing.

Multinodular goiter

Diagnosis of multinodular goiter

To diagnose multinodular goiter, the following tests can be performed:

  • Physical exploration
  • ECO-PAA ; Is useful if one of the nodules is dominant or suspected of malignancy.
  • Blood analysis ; To determine antithyroid antibodies and thus rule out thyroiditis (inflammation of the thyroid gland).
  • Thyroid scan ; To detect functioning or poor functioning nodules.
  • TAC, RM ; To assess thyroid size.


When to operate a multinodular goiter?

  • As prophylaxis of compressive complications of adjacent anatomical structures.
  • Suspicion of malignancy.
  • Compression syndrome.
  • Hyperthyroidism.


Surgical techniques to treat multinodular goiter

  • Total or subtotal thyroidectomy (complete or partial removal of the thyroid gland).



For more information consult the specialist in General Surgery .

*Translated with Google translator. We apologize for any imperfection

By Dr. Ramón Díaz Conradi

Dr. Diaz Conradi has made since 1990 over 3,200 interventions in Laparoscopic Surgery, covering all types of digestive diseases (liver, gallbladder, bile duct, pancreas, esophagus, stomach, small intestine, colon and rectum), spleen, morbid obesity (bands and by-pass), adrenal surgery and emergency surgery (abdominal trauma, acute appendicitis, cholecystitis, intestinal obstruction, perforation of hollow viscera and urgent adnexal pathology). In addition, he is a frequent speaker and lecturer at the Universidad San Pablo CEU.

*Translated with Google translator. We apologize for any imperfection

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