THE THYROID NODULE
THE THYROID NODULE Leonard Wartofsky Andrew J. Ahmann The clinical management of nodular thyroid disease is controversial.1,2,3,4,5,6,7,8,9,10,11 and 12 The finding of a thyroid nodule poses considerable anxiety for patient…
SUBSTERNAL GOITER
SUBSTERNAL GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ Substernal goiter refers to thyroidal enlargement, the major portion of which is inferior to the thoracic inlet.75 Most substernal goiters are…
TREATMENT OF NONTOXIC GOITER
TREATMENT OF NONTOXIC GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ The approach to managing nontoxic goiter involves (a) prevention of progressive enlargement of the thyroid gland; (b) anticipation, where…
PROGNOSIS OF NONTOXIC GOITER
PROGNOSIS OF NONTOXIC GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ In young or middle-aged patients, particularly those with non-toxic gland enlargement due to Hashimoto thyroiditis, goiter may remit spontaneously….
ESTABLISHMENT OF THE CAUSE OF NONTOXIC GOITER
ESTABLISHMENT OF THE CAUSE OF NONTOXIC GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ Serum antithyroid antibody titers should be measured in all patients with nontoxic goiter. Elevated antibody titers…
LABORATORY EVALUATION OF THE PATIENT WITH GOITER
LABORATORY EVALUATION OF THE PATIENT WITH GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ The principles of diagnostic evaluation of the patient with non-toxic goiter are: (a) confirmation of eumetabolism;…
NONTHYROIDAL ANTERIOR CERVICAL NECK MASSES
NONTHYROIDAL ANTERIOR CERVICAL NECK MASSES Part of “CHAPTER 38 – NONTOXIC GOITER“ The thyroidal origin of neck masses is usually apparent from their location and their movement with the thyroid…
CLINICAL FEATURES OF NONTOXIC GOITER
CLINICAL FEATURES OF NONTOXIC GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ HISTORY AND PHYSICAL FINDINGS Patients with nontoxic goiter have no systemic symptoms, and the goiter is usually found…
SPECIFIC ETIOLOGIES OF GOITER
SPECIFIC ETIOLOGIES OF GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ CONGENITAL GOITER Congenital goiter is either familial—that is, an expression of genetic disorders of intrathyroidal hormonogenesis (see Chap. 47)—or…
PATHOGENESIS OF NONTOXIC GOITER
PATHOGENESIS OF NONTOXIC GOITER Part of “CHAPTER 38 – NONTOXIC GOITER“ Nontoxic goiter is the result of an interplay of factors intrinsic and extrinsic to the thyroid. In most patients,…
