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Goiter

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Functions of Thyroid Hormones

Functions of Thyroid Hormones

The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...

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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

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How shall we manage the incidentally found thyroid nodule?

Sebastian R Aspinall¹, Sarah G S Ong, Michael S J Wilson

¹Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH, United Kingdom. sebastianaspinall@yahoo.co.uk

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

|January 15, 2013

Summary

Thyroid incidentalomas found on imaging are as likely to be malignant as palpable nodules. Current guidelines may miss some cancers, but the clinical significance of small, indolent thyroid cancers remains debated.

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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

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Mixed Reality Assisted Radical Endoscopic Thyroidectomy

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Published on: January 31, 2025

Area of Science:

Endocrinology
Radiology
Oncology

Background:

Thyroid incidentalomas are frequently discovered during neck imaging.
Their malignancy risk is comparable to palpable thyroid nodules.
Current management guidelines are inconsistent and pose challenges.

Purpose of the Study:

To review the evidence supporting current guidelines for investigating thyroid incidentalomas.
To propose a practical management strategy for these findings.

Main Methods:

Review of existing evidence and clinical guidelines.
Analysis of the diagnostic accuracy of ultrasonography and fine needle aspiration biopsy.
Discussion of the natural history and clinical significance of incidentalomas.

Main Results:

Ultrasonography has limitations in differentiating benign from malignant nodules.
Selective use of fine needle aspiration biopsy is recommended to prevent over-diagnosis.
A proportion of malignant incidentalomas may be missed under current protocols.

Conclusions:

Management of thyroid incidentalomas requires careful consideration due to conflicting guidelines.
Predicting the behavior of malignant incidentalomas is challenging.
A pragmatic approach is needed to balance detection of aggressive cancers with avoidance of overtreatment.