A goitre is an enlargement of the thyroid gland ( Fig. 25 ). It can result from physiological causes such as puberty (due to increased demand for thyroid hormone) which require no treatment, to frank malignant disease requiring urgent diagnosis and treatment.

Figure 25
Endemic goitre .
This condition, caused by iodine deficiency, is extremely common in isolated mountainous regions. The thyroid may reach enormous size yet the symptoms are minimal and the patient is usually euthyroid .

Causes

Simple (non-toxic) goitre

  • Simple hyperplastic goitre

  • Multinodular goitre

Toxic goitre

  • Diffuse goitre (Graves’ disease)

  • Toxic nodule

  • Toxic multinodular goitre

Autoimmune

  • Hashimoto’s thyroiditis

Neoplastic goitre

Benign

  • Adenoma

Malignant

  • Papillary

  • Follicular

  • Anaplastic

  • Medullary

  • Lymphoma

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