Goiter: Symptoms, Causes, Treatment & Types

Goiter: Symptoms, Causes, Treatment & Types

Define and classify goiters. Describe differentiating features between primary and secondary thyrotoxicosis along with medical treatment to make patient euthyroid.

Answer. Diffuse enlargement of thyroid gland is described as goiter.

Classifiation of Goiter

Simple goitre:

• • Puberty goitre
  • Colloid goitre
  • Iodine-defiiency goitre
  • Multinodular goitre.

“Best Practices For Managing Goiter Treatment”

Toxic goitre:

• • Graves disease
  • Secondary thyrotoxicosis in multinodular goitre
  • Solitary nodule
  • Other causes.

“What Happens If A Goiter Is Untreated”

Neoplastic goitre:

• • Benign adenoma (Follicular adenoma)
  • Malignant tumors; They are further classifid into

A.PRIMARY

• Well-diffrentiated carcinoma
  • Papillary carcinoma
  • Follicular carcinoma.
• Poorly diffrentiated carcinoma
  • Anaplastic carcinoma
• Arising from parafollicular cells
  • Medullary carcinoma.
• Arising from lymphatic tissue
  • Malignant lymphoma.

“The Role Of Ultrasound In Diagnosing A Goiter”

B.SECONDARY (Metastasis)

• Malignant melanoma, renal cell carcinoma, breast carcinoma produce
• secondaries in the thyroid, due to blood spread.

Thyroiditis

• • Granulomatous thyroiditis
  • Autoimmune thyroiditis
  • Riedel’s thyroiditis.

“Tips To Prevent Complications From A Goiter”

Other rare causes of goitre

• • Acute bacterial thyroiditis
  • Thyroid cyst
  • Thyroid abscess
  • Amyloid goitres.

Differentiating Features between Primary and Secondary thyrotoxicosis

“Comprehensive Overview Of Goiter Symptoms”

Medical treatment to Make Patient euthyroid

• Carbimazole 10 mg 6 to 8 hourly intervals daily, till the patient is euthyroid, after 8 to 12 weeks dosage may be reduced to 5 mg 8 hourly.
  Last dose is given in the evening before surgery.
• Propyl thiouracil is given as 200 mg 8 hourly.
• Lugol’s iodine, i.e. 5% iodine in 10% potassium iodide solution: 10 drops TDS for 2 weeks before operation to reduce vascularity.
• Thyroxine 0.1 mg daily to prevent TSH stimulation which may increase size and vascularity of the gland.