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===Natural History===
===Natural History===


*Slow growth of the nodules is observed in benign goiter.
*Slow growth of the nodules is observed in [[benign]] goiter.
*Rapid growth and large size of goiter causing compressive symptoms ([[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="pmid28862050">{{cite journal| author=Brandehoff N, Adams A, McDaniel K, Banister SD, Gerona R, Monte AA| title=Synthetic cannabinoid "Black Mamba" infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort. | journal=Clin Toxicol (Phila) | year= 2017 | volume=  | issue=  | pages= 1-6 | pmid=28862050 | doi=10.1080/15563650.2017.1357826 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28862050  }} </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>
*Rapid growth and large size of goiter causing compressive symptoms ([[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="pmid28862050">{{cite journal| author=Brandehoff N, Adams A, McDaniel K, Banister SD, Gerona R, Monte AA| title=Synthetic cannabinoid "Black Mamba" infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort. | journal=Clin Toxicol (Phila) | year= 2017 | volume=  | issue=  | pages= 1-6 | pmid=28862050 | doi=10.1080/15563650.2017.1357826 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28862050  }} </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 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>
*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 gland''
**''Complications related to the enlarged gland''
**''Complications related to thyroidectomy''
**''Complications related to [[thyroidectomy]]''


*'''''Complications related to the enlarged gland:'''''
*'''''Complications related to the enlarged gland:'''''
**Tracheal obstruction → airway obstruction
**Tracheal obstruction leading to [[airway obstruction]]
**Secondary thyrotoxicosis
**Secondary [[thyrotoxicosis]]
**Malignant transformation
**[[Malignant transformation]]


*'''''Complications related to thyroidectomy:'''''
*'''''Complications related to thyroidectomy:'''''
**Haemorrhage
**[[Haemorrhage]]
**Respiratory obstruction
**Respiratory obstruction
**Recurrent laryngeal nerve palsy
**Recurrent [[laryngeal nerve palsy]]
**Thyroid storm  
**[[Thyroid storm]]
**Thyroid insufficiency
**Thyroid insufficiency
**Parathyroid insufficiency
**Parathyroid insufficiency
**Wound infection
**Wound infection
**Hypertrophic scar
**[[Hypertrophic scar]]
**Keloids
**[[Keloids]]


===Prognosis===
===Prognosis===
*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>
*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==

Revision as of 18:58, 26 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

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 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

  • Common complications of goiter include:[1][3][4][5]
    • Complications related to the enlarged gland
    • Complications related to thyroidectomy

Prognosis

  • Prognosis is generally good for benign goiters. [6]
  • 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. ↑ 1.0 1.1 "Reorganized text". JAMA Otolaryngol Head Neck Surg. 141 (5): 428. 2015. doi:10.1001/jamaoto.2015.0540. PMID 25996397.
  2. ↑ Brandehoff N, Adams A, McDaniel K, Banister SD, Gerona R, Monte AA (2017). "Synthetic cannabinoid "Black Mamba" infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort". Clin Toxicol (Phila): 1–6. doi:10.1080/15563650.2017.1357826. PMID 28862050.
  3. ↑ 3.0 3.1 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.

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