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Multinodular Goiter

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81. Parapharyngeal ectopic thyroid mimicking deep lobe parotid tumour along with multinodular thyroid goitre—a very rare presentation (Full text)

Parapharyngeal ectopic thyroid mimicking deep lobe parotid tumour along with multinodular thyroid goitre—a very rare presentation 22184631 2012 04 05 2018 11 13 0250-832X 41 1 2012 Jan Dento maxillo facial radiology Dentomaxillofac Radiol Parapharyngeal ectopic thyroid mimicking deep lobe parotid tumour along with multinodular thyroid goitre--a very rare presentation. 89-90 10.1259/dmfr/41618957 Sidana S S Millet B B Moss C C eng Case Reports Letter England Dentomaxillofac Radiol 7609576 0250 (...) -832X D Adenoma, Pleomorphic diagnosis Aged Choristoma complications diagnostic imaging Diagnosis, Differential Female Goiter, Nodular complications Humans Paraganglioma diagnosis Parotid Diseases complications diagnostic imaging Parotid Neoplasms diagnostic imaging Radiography Thyroid Gland diagnostic imaging 2011 12 21 6 0 2011 12 21 6 0 2012 4 6 6 0 ppublish 22184631 41/1/89 10.1259/dmfr/41618957 PMC3520279 Singapore Med J. 2008 May;49(5):e137-8 18465039 Head Neck. 1996 Jan-Feb;18(1):67-77

2012 Dentomaxillofacial Radiology PubMed abstract

82. Serum thyrotrophin concentration: an unreliable test for detection of early hypothyroidism after thyroidectomy. (Full text)

Serum thyrotrophin concentration: an unreliable test for detection of early hypothyroidism after thyroidectomy. Three groups of patients who had undergone subtotal thyroidectomy for Graves's disease, toxic multinodular goitre, or euthyroid multinodular goitre 12 to 15 years before and in whom a normal serum thyroxine (T-4) level was found were each divided into two subgroups on the basis of a normal or a raised serum thyrotrophin concentration. There was no difference in mean serum T-4 (...) concentration between patients with normal and those with raised serum thyrotrophin concentrations, and the values were similar to the mean T-4 values of the normal population. The mean serum triiodothyronine values of all groups were higher than normal, but the mean values of the groups with a normal and a raised serum thyrotrophin were similar. After thyroidectomy a mildly raised serum thyrotrophin does not in itself indicate the presence of hypothyroidism.

1975 British medical journal PubMed abstract

83. Malignancy rate in nondominant nodules in patients with multinodular goiter: Experience with 1,606 cases evaluated by ultrasound-guided fine needle aspiration cytology (Full text)

Malignancy rate in nondominant nodules in patients with multinodular goiter: Experience with 1,606 cases evaluated by ultrasound-guided fine needle aspiration cytology Conventional medical sources recommend the use of fine needle aspiration cytology (FNAC) for single thyroid nodules and the dominant nodule in multinodular goiter (MNG). The purpose of the present study was to analyze the utility of FNAC for multiple thyroid nodules in patients with MNG and to determine the rate of malignancy

2011 CytoJournal PubMed abstract

84. Modified-release recombinant human TSH (MRrhTSH) augments the effect of (131)I therapy in benign multinodular goiter: results from a multicenter international, randomized, placebo-controlled study. (Full text)

Modified-release recombinant human TSH (MRrhTSH) augments the effect of (131)I therapy in benign multinodular goiter: results from a multicenter international, randomized, placebo-controlled study. Recombinant human TSH (rhTSH) can be used to enhance (131)I therapy for shrinkage of multinodular goiter (MG).The objective of the study was to compare the efficacy and safety of 0.01 and 0.03 mg modified-release (MR) rhTSH as an adjuvant to (131)I therapy, vs. (131)I alone, in a randomized, placebo (...) , with no significant difference among the groups. Goiter-related symptoms were effectively reduced and there were no major safety concerns.In this dose-selection study, 0.03 mg MRrhTSH was the most efficacious dose as an adjuvant to (131)I therapy of MG. It was well tolerated and significantly augmented the effect of (131)I therapy in the short term. Larger studies with long-term follow-up are warranted.

2011 The Journal of clinical endocrinology and metabolism Controlled trial quality: predicted high PubMed abstract

85. A retrosternal retrotracheal multinodular goitre (Full text)

A retrosternal retrotracheal multinodular goitre 22701027 2013 09 03 2018 11 13 1757-790X 2011 2011 Apr 15 BMJ case reports BMJ Case Rep A retrosternal retrotracheal multinodular goitre. 10.1136/bcr.01.2011.3758 bcr0120113758 Mistry Dipak D Department of ITU, Homerton University Hospital, London, UK. d.a.mistry@btinternet.com eng Case Reports Journal Article 2011 04 15 England BMJ Case Rep 101526291 1757-790X IM Female Goiter, Nodular diagnosis Goiter, Substernal diagnosis Humans Magnetic

2011 BMJ case reports PubMed abstract

86. Approach to the patient with nontoxic multinodular goiter. (Full text)

Approach to the patient with nontoxic multinodular goiter. Thyroid nodules are very common, and although the majority are benign, approximately 5% may harbor malignancy. The evaluation of the patient with solitary thyroid nodule is generally straightforward and will typically include measurement of serum TSH to assess thyroid function and fine-needle aspiration biopsy of the nodule, with or without ultrasound (US) guidance. The approach to the patient with nontoxic multinodular goiter (...) , patients with such nodules are generally advised to have surgery, unless autonomous function of these nodules can be confirmed by scintigraphy. Most of these patients, however, will ultimately prove to have benign follicular tumors. Many patients with benign but large goiters may experience clinical symptoms of pressure, such as dysphagia, choking sensation, or airway obstruction. Such patients will often require surgery for alleviation of symptoms. In the absence of malignancy, asymptomatic patients

2011 Journal of Clinical Endocrinology and Metabolism PubMed abstract

87. Multinodular thyroid goitre causing obstructive sleep apnoea syndrome. (Abstract)

Multinodular thyroid goitre causing obstructive sleep apnoea syndrome. Obstructive sleep apnoea syndrome has been linked to obesity, nasal obstruction and adenotonsillar hypertrophy, but rarely to large thyroid goitres.To study the possible association between multinodular retrolaryngo-pharyngeal or retrosternal goitres and obstructive sleep apnoea syndrome.Retrospective case series at a tertiary referral centre (2000-2010). Study parameters included body mass index, Epworth sleep score (...) and polysomnographic index.Five patients were diagnosed with obstructive sleep apnoea syndrome and managed with nasal continuous positive airway pressure ventilation. Computed tomography showed a retrolaryngo-pharyngeal or retrosternal goitre with significant tracheal compression, displacement and laryngeal oedema. After total thyroidectomy, obstructive sleep apnoea resolved in all patients.Large, multinodular goitres with retrolaryngo-pharyngeal extension can cause obstructive sleep apnoea syndrome due

2011 Journal of Laryngology & Otology

88. Multinodular goitre arising in the tracheal lumen: implantation or ectopic? (Abstract)

Multinodular goitre arising in the tracheal lumen: implantation or ectopic? We report a case of multinodular goitre arising in thyroid tissue within the trachea. This tissue appears to have been implanted at the time of an earlier subtotal thyroidectomy.A 79-year-old woman presented with a 12-month history of dyspnoea. Forty years earlier, she had been treated for a follicular adenoma with subtotal thyroidectomy. Investigation revealed tumour in the region of the right lobe of the thyroid (...) , extending into and narrowing the trachea. A biopsy was performed, and the patient underwent excision of the right thyroid lobe tumour and cricotracheal resection with anastomosis. Histopathological findings were consistent with a multinodular goitre arising in thyroid tissue within the tracheal lumen.Intra-operative thyroid tissue implantation in the trachea and subsequent goitre development has not previously been described. This case illustrates the need for careful resection of the thyroid in order

2011 Journal of Laryngology & Otology

89. Unanticipated Thyroid Cancer in Patients with Substernal Goiters: Are We Underestimating the Risk? (Abstract)

Unanticipated Thyroid Cancer in Patients with Substernal Goiters: Are We Underestimating the Risk? The rate of unexpected thyroid cancers found at the time of thyroidectomy is thought to be similar in patients with cervical and substernal multinodular goiters (MNGs).The objective of this study was to compare the prevalence of undiagnosed cancer found in patients undergoing a thyroidectomy for a cervical or substernal MNG. We conducted a review of patients with a preoperative diagnosis of an MNG

2014 Annals of Surgical Oncology

90. The Role of Levothyroxine on Goiter With Atypia of Undetermined Significance

who have multinodular goiter demonstrated by thyroid sono and positive autoantibody of thyroglobulin with pathological reports of fine needle aspiration showing atypical undetermined of significance will take eltroxin for TSH suppression therapy to ameliorate of goiter Drug: Levothyroxine Other Name: Eltroxin Active Comparator: Multigoiter, ATA (-), AUS (+) on Tx The patients who have multinodular goiter demonstrated by thyroid sono and negative autoantibody of thyroglobulin with pathological (...) reports of fine needle aspiration showing atypical undetermined of significance will take eltroxin for TSH suppression therapy to ameliorate of goiter Drug: Levothyroxine Other Name: Eltroxin No Intervention: Multigoiter, ATA (+), AUS (+) without Tx The patients who have multinodular goiter demonstrated by thyroid sono and positive autoantibody of thyroglobulin with pathological reports of fine needle aspiration showing atypical undetermined of significance decide not to take eltroxin for TSH

2014 Clinical Trials

91. Goiter, Nontoxic (Overview)

. Etiopathology, clinical features, and treatment of diffuse and multinodular nontoxic goiters. J Endocrinol Invest . 2015 Sep 21. . Baloch ZW, LiVolsi VA. Fine-needle aspiration of the thyroid: today and tomorrow. Best Pract Res Clin Endocrinol Metab . 2008 Dec. 22(6):929-39. . Lang BH, Zhi H, Cowling BJ. Assessing perioperative body weight changes in patients thyroidectomized for a benign nontoxic nodular goitre. Clin Endocrinol (Oxf) . 2015 Sep 19. . Agarwal G, Aggarwal V. Is total thyroidectomy (...) the surgical procedure of choice for benign multinodular goiter? An evidence-based review. World J Surg . 2008 Jul. 32(7):1313-24. . Weetman AP. Radioiodine treatment for benign thyroid diseases. Clin Endocrinol (Oxf) . 2007 Jun. 66(6):757-64. . Baczyk M, Pisarek M, Czepczynski R, Ziemnicka K, Gryczynska M, Pietz L, et al. Therapy of large multinodular goitre using repeated doses of radioiodine. Nucl Med Commun . 2009 Mar. 30(3):226-31. . Bonnema SJ, Hegedus L. A 30-year perspective on radioiodine therapy

2014 eMedicine.com

92. Goiter, Toxic Nodular (Overview)

in patients with nodular goitre: a meta-analysis of randomized controlled trials. Clin Endocrinol (Oxf) . 2015 Nov. 83 (5):702-10. . Adamali HI, Gibney J, O'Shea D, Casey M, McKenna TJ. The occurrence of hypothyroidism following radioactive iodine treatment of toxic nodular goiter is related to the TSH level. Ir J Med Sci . 2007 Sep. 176 (3):199-203. . Adamali HI, Gibney J, O'Shea D, et al. The occurrence of hypothyroidism following radioactive iodine treatment of toxic nodular goiter is related (...) , Schneider DF, Nookala R, Broome JT, Sippel RS, et al. Toxic nodular goiter and cancer: a compelling case for thyroidectomy. Ann Surg Oncol . 2013 Apr. 20(4):1336-40. . Cirocchi R, Trastulli S, Randolph J, Guarino S, Di Rocco G, Arezzo A, et al. Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults. Cochrane Database Syst Rev . 2015 Aug 7. CD010370. . Sung JY, Baek JH, Jung SL, Kim JH, Kim KS, Lee D, et al. Radiofrequency ablation for autonomously

2014 eMedicine.com

93. Goiter (Overview)

relationship of the thyroid gland to the trachea, larynx, superior and inferior laryngeal nerves, and esophagus, abnormal growth may cause a variety of compressive syndromes. Thyroid function may be normal (nontoxic goiter), [ ] overactive (toxic goiter), or underactive (hypothyroid goiter). Next: Pathophysiology The thyroid gland is controlled by thyroid-stimulating hormone (TSH; also known as thyrotropin), secreted from the pituitary gland, which in turn is influenced by the thyrotropin-releasing hormone (...) from compression of surrounding structures, thyroid cancer, hyperthyroidism, or hypothyroidism. Race No racial predilection exists. Sex The female-to-male ratio is 4:1. In the Wickham study, 26% of women had a goiter, compared to 7% of men. [ ] Thyroid nodules are less frequent in men than in women, but when found, they are more likely to be malignant. Age The frequency of goiters decreases with advancing age. The decrease in frequency differs from the incidence of thyroid nodules, which increases

2014 eMedicine.com

94. Goiter, Toxic Nodular (Follow-up)

Res . 2012 Dec. 24(6):714-7. . Lee YY, Tam KW, Lin YM, Leu WJ, Chang JC, Hsiao CL, et al. Recombinant human thyrotropin before (131)I therapy in patients with nodular goitre: a meta-analysis of randomized controlled trials. Clin Endocrinol (Oxf) . 2015 Nov. 83 (5):702-10. . Adamali HI, Gibney J, O'Shea D, Casey M, McKenna TJ. The occurrence of hypothyroidism following radioactive iodine treatment of toxic nodular goiter is related to the TSH level. Ir J Med Sci . 2007 Sep. 176 (3):199-203 (...) Alerts for Human Medical Products. Propylthiouracil (PTU). US Food and Drug Administration. Accessed: June 3, 2009. Available at . Smith JJ, Chen X, Schneider DF, Nookala R, Broome JT, Sippel RS, et al. Toxic nodular goiter and cancer: a compelling case for thyroidectomy. Ann Surg Oncol . 2013 Apr. 20(4):1336-40. . Cirocchi R, Trastulli S, Randolph J, Guarino S, Di Rocco G, Arezzo A, et al. Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults

2014 eMedicine.com

95. Goiter, Nontoxic (Follow-up)

in patients thyroidectomized for a benign nontoxic nodular goitre. Clin Endocrinol (Oxf) . 2015 Sep 19. . Agarwal G, Aggarwal V. Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? An evidence-based review. World J Surg . 2008 Jul. 32(7):1313-24. . Weetman AP. Radioiodine treatment for benign thyroid diseases. Clin Endocrinol (Oxf) . 2007 Jun. 66(6):757-64. . Baczyk M, Pisarek M, Czepczynski R, Ziemnicka K, Gryczynska M, Pietz L, et al. Therapy of large multinodular (...) goitre using repeated doses of radioiodine. Nucl Med Commun . 2009 Mar. 30(3):226-31. . Bonnema SJ, Hegedus L. A 30-year perspective on radioiodine therapy of benign nontoxic multinodular goiter. Curr Opin Endocrinol Diabetes Obes . 2009 Oct. 16(5):379-84. . Duntas LH, Cooper DS. Review on the occasion of a decade of recombinant human TSH: prospects and novel uses. Thyroid . 2008 May. 18(5):509-16. . Medeiros-Neto G, Marui S, Knobel M. An outline concerning the potential use of recombinant human

2014 eMedicine.com

96. Goiter (Follow-up)

with preoperative hyperthyroidism or hypothyroidism. Postoperative management also includes monitoring of serum calcium. A literature review by Li et al indicated that total thyroidectomy is a safe procedure for the treatment of bilateral multinodular nontoxic goiter, demonstrating a lower recurrence rate than bilateral subtotal thyroidectomy. However, total thyroidectomy was also found to carry a significantly higher risk of postoperative transient hypoparathyroidism than did the other procedure. [ ] A study (...) goiter may be reduced with levothyroxine suppressive therapy. The patient is monitored to keep serum TSH in a low but detectable range to avoid hyperthyroidism, cardiac arrhythmias, and osteoporosis. The patient has to be compliant with monitoring. Some authorities suggest suppressive treatment for a definite time period instead of indefinite therapy. Patients with Hashimoto thyroiditis respond better. Treatment of hypothyroidism or hyperthyroidism often reduces the size of a goiter. Thyroid hormone

2014 eMedicine.com

97. Goiter, Diffuse Toxic (Treatment)

== processing > Diffuse Toxic Goiter (Graves Disease) Treatment & Management Updated: Jul 27, 2015 Author: Bernard Corenblum, MD, FRCPC; Chief Editor: George T Griffing, MD Share Email Print Feedback Close Sections Sections Diffuse Toxic Goiter (Graves Disease) Treatment Medical Care Even though the natural history of diffuse toxic goiter is to possibly spontaneously remit (and perhaps later relapse), or even progress into hypothyroidism, observation without intervention, even in minimally symptomatic (...) Endocrinologists have released guidelines for the management of hyperthyroid and other causes of thyrotoxicosis, including the use of radioactive iodine or surgery to treat toxic multinodular goiter. [ ] Therapy may be by subtotal thyroidectomy, administration of radioiodine, antithyroid drugs, or a combination of these. In North America, radioiodine is the most common treatment and is available for all ages. Adjunctive symptomatic therapy, such as beta-blockers, may help adrenergic symptoms. Nonsurgical

2014 eMedicine.com

98. Goiter, Nontoxic (Treatment)

, clinical features, and treatment of diffuse and multinodular nontoxic goiters. J Endocrinol Invest . 2015 Sep 21. . Baloch ZW, LiVolsi VA. Fine-needle aspiration of the thyroid: today and tomorrow. Best Pract Res Clin Endocrinol Metab . 2008 Dec. 22(6):929-39. . Lang BH, Zhi H, Cowling BJ. Assessing perioperative body weight changes in patients thyroidectomized for a benign nontoxic nodular goitre. Clin Endocrinol (Oxf) . 2015 Sep 19. . Agarwal G, Aggarwal V. Is total thyroidectomy the surgical (...) procedure of choice for benign multinodular goiter? An evidence-based review. World J Surg . 2008 Jul. 32(7):1313-24. . Weetman AP. Radioiodine treatment for benign thyroid diseases. Clin Endocrinol (Oxf) . 2007 Jun. 66(6):757-64. . Baczyk M, Pisarek M, Czepczynski R, Ziemnicka K, Gryczynska M, Pietz L, et al. Therapy of large multinodular goitre using repeated doses of radioiodine. Nucl Med Commun . 2009 Mar. 30(3):226-31. . Bonnema SJ, Hegedus L. A 30-year perspective on radioiodine therapy of benign

2014 eMedicine.com

99. Goiter, Toxic Nodular (Treatment)

):714-7. . Lee YY, Tam KW, Lin YM, Leu WJ, Chang JC, Hsiao CL, et al. Recombinant human thyrotropin before (131)I therapy in patients with nodular goitre: a meta-analysis of randomized controlled trials. Clin Endocrinol (Oxf) . 2015 Nov. 83 (5):702-10. . Adamali HI, Gibney J, O'Shea D, Casey M, McKenna TJ. The occurrence of hypothyroidism following radioactive iodine treatment of toxic nodular goiter is related to the TSH level. Ir J Med Sci . 2007 Sep. 176 (3):199-203. . Adamali HI, Gibney J (...) Products. Propylthiouracil (PTU). US Food and Drug Administration. Accessed: June 3, 2009. Available at . Smith JJ, Chen X, Schneider DF, Nookala R, Broome JT, Sippel RS, et al. Toxic nodular goiter and cancer: a compelling case for thyroidectomy. Ann Surg Oncol . 2013 Apr. 20(4):1336-40. . Cirocchi R, Trastulli S, Randolph J, Guarino S, Di Rocco G, Arezzo A, et al. Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults. Cochrane Database Syst Rev

2014 eMedicine.com

100. Goiter, Lithium-Induced (Treatment)

> Lithium-Induced Goiter Treatment & Management Updated: Feb 27, 2015 Author: Nicholas J Sarlis, MD, PhD, FACP; Chief Editor: George T Griffing, MD Share Email Print Feedback Close Sections Sections Lithium-Induced Goiter Treatment Medical Care Because as many as one fourth to one third of patients on long-term lithium therapy develop hypothyroidism, provide regular follow-up care on a clinical and biochemical basis for symptoms and signs of hypothyroidism and increased serum thyrotropin levels (...) , respectively. Before the initiation of lithium therapy, identify patients at increased risk for the development of hypothyroidism (eg, patients originating from iodine-deficient areas, those with a strong family history of thyroid disorders, women, elderly patients, patients exposed to other goitrogens). Suspicion of goiter upon physical examination may prompt the physician to order ultrasonography to record the baseline dimensions of the thyroid gland and to exclude underlying structural thyroid disease

2014 eMedicine.com

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