Nodular goiter is a group of thyroid gland diseases that occur with the development of volumetric nodal formations of various origin and morphology. Diagnosis of nodular goiter is based on palpation data, thyroid ultrasound, thyroid hormone indices, fine needle biopsy, scintigraphy, esophageal radiography, CT or MRI. Treatment of nodular goiter may include suppressive therapy with thyroid hormone drugs, radioactive iodine therapy, hemithyroidectomy or thyroidectomy.
Causes of nodular goiter
The causes of the development of thyroid nodules are not known to the end. Thus, the appearance of toxic adenomas of the thyroid gland is associated with a mutation of the TSH receptor gene and a-subunits of G proteins, which inhibit the activity of adenylate cyclase. Hereditary and somatic mutations are also found in medullary thyroid cancer.
The etiology of nodular colloid proliferating goiter is unclear: It is often considered as an age-related transformation of the thyroid gland. In addition, the occurrence of colloid goiter predisposes iodine deficiency. In regions with iodine deficiency, cases of multinodal goiter with thyrotoxicosis phenomena are not uncommon.
Symptoms of nodular goiter
In most cases, nodular goiter does not have clinical manifestations. Large nodal formations present themselves as a visible cosmetic defect in the neck region a noticeable thickening of its anterior surface. In nodular goitre, the enlargement of the thyroid gland occurs predominantly asymmetrically.
As the nodes grow, they begin to squeeze the neighboring organs (esophagus, trachea, nerves and blood vessels), which is accompanied by the development of mechanical symptoms of nodular goiter. The compression of the larynx and trachea is manifested by a sensation of a lump in the throat, a constant hoarse voice, an increasing difficulty in breathing, a prolonged dry cough, and suffocation. Compression of the esophagus leads to difficulty swallowing.
Treatment of nodular goiter
The treatment of nodular goiter is differentiated. It is believed that special treatment of nodular colloid proliferative goiter is not required. If the nodular goiter does not disrupt the function of the thyroid gland, has small dimensions, does not represent a threat of compression or a cosmetic problem, then in this form the patient is followed by a dynamic observation of the endocrinologist. A more active tactic is indicated if the nodular goiter shows a tendency to rapid progression.