Fact-sheet: Goiter


Updated on 08/26/2020 at 2:00 PM

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Definition

Diffuse enlargement of the thyroid body.

Goiter is defined when the thyroid volume (2 lobes and isthmus) is:
> 20 mL in men,
> 18 mL in women,
> 16 mL in adolescents

Predominantly affects women after puberty.
Etiologies include iodine deficiency, smoking, certain foods, lithium, and substances that interfere with iodine metabolism.

Goiter may be simple or multinodular.

Clinical features

  • Neck mass
  • Dyspnea, tracheal stenosis, then tracheomalacia in advanced forms
  • Dysphagia
  • Dysphonia
  • Pemberton's maneuver: facial congestion and jugular vein distension after raising the arms against the ears for more than one minute

Laboratory findings

  • Abnormal TSH

Radiography

Upper GI series: esophageal compression.

Ultrasound

First-line examination. Use of trapezoid or panoramic mode. Use of a microconvex probe in case of a retrosternal goiter

  • Thyroid volume calculation
  • Search for nodules
  • Swallowing to assess esophageal compression

CT

  • Evaluation of a retrosternal goiter.

Nuclear medicine

Scintigraphy to assess hyperfunctioning or non-functioning status in case of nodules

Classification

WHO criteria:

  • 0 A: no goiter
  • 0 B: palpable but not visible goiter
  • 1: goiter visible with slight neck extension
  • 2: goiter visible from a distance