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Related Concept Videos

Goiter01:27

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...
Hyperthyroidism II: Pathophysiology01:27

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...
The Thyroid Gland01:23

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...
Hyperthyroidism I: Introduction01:25

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...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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Published on: September 20, 2024

The neoplastic goitre.

Iain J Nixon1, Ricard Simo

  • 1Department of Head and Neck Surgery, Memorial Sloan Ketttering Cancer Center, New York, NY, USA

Current Opinion in Otolaryngology & Head and Neck Surgery
|February 7, 2013
PubMed
Summary
This summary is machine-generated.

Multinodular goitre (MNG) has a significant risk of malignancy, particularly in younger men and those with specific risk factors. Total thyroidectomy or lobectomy is now preferred for MNG management.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroidology

Background:

  • Multinodular goitre (MNG) is a common thyroid condition with varying malignancy risks.
  • Accurate assessment and management are crucial for patient outcomes.

Purpose of the Study:

  • Review recent advances in MNG malignancy risk and evaluation.
  • Discuss predictive factors for malignancy in MNG.
  • Outline optimal surgical approaches for neoplastic MNG.

Main Methods:

  • Literature review of recent studies on MNG incidence and malignancy.
  • Analysis of risk factors and predictive markers for MNG-associated cancer.
  • Evaluation of surgical techniques for neoplastic MNG.

Main Results:

  • MNG incidence ranges from 10-70% by ultrasound; occult malignancy is 10-35% in surgical series.
  • Higher malignancy rates observed in younger patients, men, and those with family history, prior irradiation, or compressive symptoms.
  • Subtotal thyroidectomy is largely replaced by total lobectomy or total thyroidectomy.

Conclusions:

  • MNG prevalence is increasing, necessitating updated management strategies.
  • Total thyroidectomy or lobectomy offers optimal outcomes, minimizing recurrence and ensuring oncological safety.
  • An oncological approach is vital for incidentally discovered malignancies within MNG.