Toxic multinodular goiter natural history, complications and prognosis

Toxic multinodular goiter Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

• If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
• Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
• Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

• If left untreated, toxic multinodular goiter may progress to develop hyperthyroidism.
• Untreated toxic multinodular goiter progresses slowly and initially presents with history of thyroid enlargement.
• Thyroid enlargement is followed by a long period of subclinical hyperthyroidism.
• Overt hyperthyroidism occurs late in the course of toxic multinodular goiter.
  • When hyperthyroidism is present, cardiac symptoms are the most common presentation such as palpitations, tachycardia, heart failure and atrial fibrillation.
  • Over the course of time, toxic multinodular goiter may increase in size and can lead to compression of surrounding structures such as trachea, esophagus or external jugular vein.

Complications

• Common complications of toxic multinodular goiter include:
  • Tachycardia
  • Arrhythmia
  • Atrial fibrillation
  • Heart failure
  • Facial pleothora
  • Inspiratory stridor
  • Hoarseness
  • Dysphagia

Prognosis

• Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
• Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
• The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
• [Subtype of disease/malignancy] is associated with the most favorable prognosis.
• The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.