Goiter natural history, complications and prognosis: Difference between revisions
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{{Goiter}} | {{Goiter}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{ARK}} | ||
==Overview== | ==Overview== | ||
Slow growth of the nodules is observed in benign goiter. | If left untreated, goiter will continue to grow in size. Slow growth of the nodules is observed in benign goiter. Rapid growth and large size of goiter causing compressive [[symptoms]] may be suggestive of [[thyroid cancer]]. Common complications of goiter include those related to the [[enlarged thyroid gland]] and those related to [[thyroidectomy]]. [[Prognosis]] is generally good for [[benign]] goiter. Although the prognosis is good and the risk is low, caution is advised to prevent the possible development of [[malignancy]]. Careful monitoring of size, shape and consistency associated with pain is recommended. [[Radiation exposure]] has been attributed to the possible development of [[malignancy]]. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
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===Natural History=== | ===Natural History=== | ||
*Slow growth of the nodules is observed in benign goiter. | *If left untreated, goiter will continue to grow in size. | ||
* | *Slow [[growth]] of the nodules is observed in [[benign]] goiter. | ||
*Rapid [[growth]] and large size of goiter causing compressive symptoms (such as [[dysphagia]], [[hoarseness]] and [[dyspnoea]]) may be suggestive of [[thyroid cancer]]. <ref name="pmid25996397">{{cite journal| author=| title=Reorganized text. | journal=JAMA Otolaryngol Head Neck Surg | year= 2015 | volume= 141 | issue= 5 | pages= 428 | pmid=25996397 | doi=10.1001/jamaoto.2015.0540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25996397 }} </ref><ref name="pmid15197094">{{cite journal| author=Shen WT, Kebebew E, Duh QY, Clark OH| title=Predictors of airway complications after thyroidectomy for substernal goiter. | journal=Arch Surg | year= 2004 | volume= 139 | issue= 6 | pages= 656-9; discussion 659-60 | pmid=15197094 | doi=10.1001/archsurg.139.6.656 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15197094 }} </ref> | |||
===Complications=== | ===Complications=== | ||
*Common complications of | *Common complications of goiter include:<ref name="pmid25996397">{{cite journal| author=| title=Reorganized text. | journal=JAMA Otolaryngol Head Neck Surg | year= 2015 | volume= 141 | issue= 5 | pages= 428 | pmid=25996397 | doi=10.1001/jamaoto.2015.0540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25996397 }} </ref><ref name="pmid15197094">{{cite journal| author=Shen WT, Kebebew E, Duh QY, Clark OH| title=Predictors of airway complications after thyroidectomy for substernal goiter. | journal=Arch Surg | year= 2004 | volume= 139 | issue= 6 | pages= 656-9; discussion 659-60 | pmid=15197094 | doi=10.1001/archsurg.139.6.656 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15197094 }} </ref><ref name="pmid11788632">{{cite journal| author=Bonnema SJ, Bennedbaek FN, Ladenson PW, Hegedüs L| title=Management of the nontoxic multinodular goiter: a North American survey. | journal=J Clin Endocrinol Metab | year= 2002 | volume= 87 | issue= 1 | pages= 112-7 | pmid=11788632 | doi=10.1210/jcem.87.1.8169 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11788632 }} </ref><ref name="pmid16434453">{{cite journal| author=Nielsen VE, Bonnema SJ, Hegedüs L| title=Transient goiter enlargement after administration of 0.3 mg of recombinant human thyrotropin in patients with benign nontoxic nodular goiter: a randomized, double-blind, crossover trial. | journal=J Clin Endocrinol Metab | year= 2006 | volume= 91 | issue= 4 | pages= 1317-22 | pmid=16434453 | doi=10.1210/jc.2005-2137 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16434453 }} </ref> | ||
** | **Complications related to the [[Enlarged thyroid gland|enlarged gland]], | ||
** | **Complications related to [[thyroidectomy]]. | ||
'''Complications related to the enlarged gland:''' | |||
*Tracheal obstruction leading to [[airway obstruction]], | |||
*Secondary [[thyrotoxicosis]], | |||
*[[Malignant transformation]]. | |||
* | '''Complications related to thyroidectomy:''' | ||
*[[Haemorrhage]] | |||
*[[Respiratory system|Respiratory]] obstruction | |||
* | *Recurrent [[laryngeal nerve palsy]] | ||
* | *[[Thyroid storm]] | ||
*[[Thyroid]] insufficiency | |||
* | *[[Parathyroid gland|Parathyroid]] insufficiency | ||
* | *[[Wound]] infection | ||
* | *[[Hypertrophic scar]] | ||
* | *[[Keloids]] | ||
* | |||
* | |||
===Prognosis=== | ===Prognosis=== | ||
*Prognosis is generally good for benign goiters. | *Prognosis is generally good for [[benign]] goiters. <ref name="pmid598014">{{cite journal| author=Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F et al.| title=The spectrum of thyroid disease in a community: the Whickham survey. | journal=Clin Endocrinol (Oxf) | year= 1977 | volume= 7 | issue= 6 | pages= 481-93 | pmid=598014 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=598014 }} </ref> | ||
*Although the prognosis is good and the risk is low, caution is advised for the possible development of malignancy. | *Although the [[prognosis]] is good and the risk is low, caution is advised for the possible development of [[malignancy]]. | ||
*Careful monitoring of size, shape and consistency associated with pain is advised. | *Careful monitoring of size, shape and consistency associated with pain is advised. | ||
*Radiation exposure has been attributed to the possible development of malignancy. | *[[Radiation exposure]] has been attributed to the possible development of [[malignancy]]. | ||
==References== | ==References== | ||
Latest revision as of 11:38, 20 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
If left untreated, goiter will continue to grow in size. Slow growth of the nodules is observed in benign goiter. Rapid growth and large size of goiter causing compressive symptoms may be suggestive of thyroid cancer. Common complications of goiter include those related to the enlarged thyroid gland and those related to thyroidectomy. Prognosis is generally good for benign goiter. Although the prognosis is good and the risk is low, caution is advised to prevent the possible development of malignancy. Careful monitoring of size, shape and consistency associated with pain is recommended. Radiation exposure has been attributed to the possible development of malignancy.
Natural History, Complications, and Prognosis
Natural History
- If left untreated, goiter will continue to grow in size.
- Slow growth of the nodules is observed in benign goiter.
- Rapid growth and large size of goiter causing compressive symptoms (such as dysphagia, hoarseness and dyspnoea) may be suggestive of thyroid cancer. [1][2]
Complications
- Common complications of goiter include:[1][2][3][4]
- Complications related to the enlarged gland,
- Complications related to thyroidectomy.
Complications related to the enlarged gland:
- Tracheal obstruction leading to airway obstruction,
- Secondary thyrotoxicosis,
- Malignant transformation.
Complications related to thyroidectomy:
- Haemorrhage
- Respiratory obstruction
- Recurrent laryngeal nerve palsy
- Thyroid storm
- Thyroid insufficiency
- Parathyroid insufficiency
- Wound infection
- Hypertrophic scar
- Keloids
Prognosis
- Prognosis is generally good for benign goiters. [5]
- Although the prognosis is good and the risk is low, caution is advised for the possible development of malignancy.
- Careful monitoring of size, shape and consistency associated with pain is advised.
- Radiation exposure has been attributed to the possible development of malignancy.
References
- ↑ 1.0 1.1 "Reorganized text". JAMA Otolaryngol Head Neck Surg. 141 (5): 428. 2015. doi:10.1001/jamaoto.2015.0540. PMID 25996397.
- ↑ 2.0 2.1 Shen WT, Kebebew E, Duh QY, Clark OH (2004). "Predictors of airway complications after thyroidectomy for substernal goiter". Arch Surg. 139 (6): 656–9, discussion 659-60. doi:10.1001/archsurg.139.6.656. PMID 15197094.
- ↑ Bonnema SJ, Bennedbaek FN, Ladenson PW, Hegedüs L (2002). "Management of the nontoxic multinodular goiter: a North American survey". J Clin Endocrinol Metab. 87 (1): 112–7. doi:10.1210/jcem.87.1.8169. PMID 11788632.
- ↑ Nielsen VE, Bonnema SJ, Hegedüs L (2006). "Transient goiter enlargement after administration of 0.3 mg of recombinant human thyrotropin in patients with benign nontoxic nodular goiter: a randomized, double-blind, crossover trial". J Clin Endocrinol Metab. 91 (4): 1317–22. doi:10.1210/jc.2005-2137. PMID 16434453.
- ↑ Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F; et al. (1977). "The spectrum of thyroid disease in a community: the Whickham survey". Clin Endocrinol (Oxf). 7 (6): 481–93. PMID 598014.