Document Detail

Approach to the patient with nontoxic multinodular goiter.
MedLine Citation:
PMID:  21543434     Owner:  NLM     Status:  In-Data-Review    
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 represents a more difficult problem for the clinician. All patients should have serum TSH measured to assess functional thyroid status and US examination to evaluate the number, size, and sonographic features of the nodules and assist in the selection of nodules that may need fine-needle aspiration biopsy. Patients with nodules yielding malignant cytology should be referred for surgery. Given the lack of reliable markers to predict biological behavior of nodules with suspicious (indeterminate) cytology, 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 may be observed. Radioactive iodine, commonly used in many parts of Europe, is safe and effective and may be a reasonable option for many patients. Periodic follow-up with neck palpation and US exam is recommended for all patients.
Rebecca S Bahn; M Regina Castro
Related Documents :
15458464 - Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and ...
8555074 - Decreased production of interferon gamma by anti-cd3 monoclonal antibody and interleuki...
1873594 - Prothrombotic hemostatic abnormalities in patients with refractory malignant lymphoma p...
19582194 - Changes of serum bone markers in capd and hemodialysis patients.
24349354 - Cardiac troponin i in non- acute coronary syndrome patients with chronic kidney disease.
17702584 - Recombinant activated factor vii for a warfarinised jehovah's witness with an acute sub...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  96     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1202-12     Citation Subset:  AIM; IM    
Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Markers of Bone Turnover in Gaucher Disease: Modeling the Evolution of Bone Disease.
Next Document:  Mechanisms of neutrophil transmigration across the vascular endothelium in COPD.