Session: Podium Presentation Program Number: S091 Post Views: 228 « Return to SAGES 2009 abstract archive [sages.org]

Nodules are clonal or polyclonal and are due to heterogeneous responses of follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter : no hyperthyroidism present Epidemiology 90% of those [pathologyoutlines.com]

Supine dyspnea was the presenting symptom in our patient, and the imaging studies excluded cardiac involvement. [rc.rcjournal.com]

Patients who presented with compressive symptoms and no prior FNA at initial presentation were included in this study. [journals.aace.com]

When increased activity and hyperthyroidism are present then the condition is referred to a toxic multinodular goiter or Plummer disease. [radiopaedia.org]

• Anemia

  […] transport within the thyroid Hereditary : see dyshormonogenetic goiter Plummer syndrome : hyperfunctioning thyroid nodule within a goiter, without ophthalmopathy or dermopathy of Graves disease Plummer-Vinson (Paterson-Kelly) syndrome : iron deficiency anemia [pathologyoutlines.com]

• Dysphasia

  Hereditary : see dyshormonogenetic goiter Plummer syndrome : hyperfunctioning thyroid nodule within a goiter, without ophthalmopathy or dermopathy of Graves disease Plummer-Vinson (Paterson-Kelly) syndrome : iron deficiency anemia, glossitis, esophageal dysphasia [pathologyoutlines.com]

If any changes occur, then further workup is indicated. Evidence-based answers from the Family Physicians Inquiries Network [mdedge.com]

[…] and pelvis (23%), however, such lesions in the long bones and skull are less common (6% each [4] Multiple bone site involvement at a given time is also quite frequent (40%), as seen in our patient. [7] Patients with metastatic disease need a complete workup [ijem.in]

• Superior Mediastinal Mass

  Nuclear medicine Tc-99m pertechnetate or radioiodine (I-123) demonstrate an enlarged gland, with heterogeneous uptake thyroid uptake scan determines the activity of the gland Plain radiograph goiter is in the differential for an anterior/superior mediastinal [radiopaedia.org]

• Free T4 Increased

  Free-T4 increased from 1.16 ± 0.24 ng/dL at D1 to 1.80 ± 0.48 ng/dL at D3 (48 h after rhTSH; P < 0.001). Mean free-T4 levels remained within the normal range in all evaluations. [scielo.br]

Three of these 8 patients had 1 131 I treatment, 4 patients had 2 treatments, and 1 patient had 3 treatments. These patients did not want subsequent 131 I treatment and were given long-term antithyroid drug treatment. [jamanetwork.com]

There is no ideal treatment for MNG. [scielo.br]

However, many diseases of the thyroid require total or near total thyroid resection for adequate treatment. [sages.org]

There is no standard treatment and choice of treatment depends on local practice patterns, the activity of the goiter, and the results of FNA of any suspicious nodules. surgery: partial or complete resection radioiodine: occasionally used dose = (thyroid [radiopaedia.org]

[…] but may be seen incidentally CT may be useful for fully characterizing the extent of substernal (retrosternal) goiter an enlarged and heterogeneous thyroid gland suggests the diagnosis, which is confirmed by ultrasound or scintigraphy Treatment and prognosis [radiopaedia.org]

The type of cancer (PTC or FTC) was not a significant indicator of prognosis. [ijem.in]

Expectations (prognosis): The prognosis is good with treatment. A persistent goiter may become toxic, causing symptoms of excess thyroid hormones to develop. [uclahealth.org]

Treatment and prognosis ----------------------------------------- Treatment of multinodular goitre may be pursued if the thyroid is hyperfunctioning, or if the goitre is causing local mass effect. [youtube.com]

Other tests that may be done include: Serum thyroid hormone levels ( T3, T4 ) Serum TSH (thyroid stimulating hormone) Thyroid uptake and scan or radioactive iodine uptake Thyroid ultrasound Outlook (Prognosis) Toxic nodular goiter is mainly a disease [account.allinahealth.org]

Treatment depends on the underlying etiology and includes, e.g., surgery ( thyroidectomy ) for malignant and autonomous nodules, fine needle aspiration for thyroid cysts, and observation for small, benign nodules. [amboss.com]

The etiology of nontoxic MNG is multifactorial, with the important factors including, among others, iodine deficiency (initially manifesting as a simple goiter), genetic predisposition, goitrogens, exposure to ionizing radiation, and history of thyroiditis [empendium.com]

However, the true etiology of most nontoxic goiters in iodine-sufficient areas is unknown. Symptoms and Signs The patient may have a history of low iodine intake or overingestion of food goitrogens, but these phenomena are rare in North America. [merckmanuals.com]

Medline, CAS, Google Scholar 17 Diez JJ: Goiter in adult patients aged 55 years and older: etiology and clinical features in 634 patients. J. [futuremedicine.com]

[…] follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter : no hyperthyroidism present Epidemiology 90% of those affected are women Develops more frequently during adolescence and pregnancy Etiology [pathologyoutlines.com]

Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Wang, C, Crapo, LM The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am 1997 ;26: 189 – 218. Google Scholar | Crossref | Medline | ISI 2. [journals.sagepub.com]

Goiter prevalence and thyroid abnormalities at ultrasonography: a complete epidemiological study in two regions with slightly different iodine status. Clin. Endocrinol. 53,479–485 ( 2000 ). [futuremedicine.com]

[…] dominant nodule is present Nodules are clonal or polyclonal and are due to heterogeneous responses of follicular epithelium to TSH Exophthalmos of Graves disease is not present Also called nodular hyperplasia Nontoxic goiter : no hyperthyroidism present Epidemiology [pathologyoutlines.com]

[…] either FNA (based on sonographic criteria) or monitoring (with repeat ultrasounds) if criteria are not met Sonographic criteria for fine-needle aspiration ( FNA ) References: [1] [3] Follicular adenoma Toxic adenoma Toxic multinodular goiter Epidemiology Pathophysiology [amboss.com]

Pathophysiology Toxic nodular goiter (TNG) represents a spectrum of disease ranging from a single hyperfunctioning nodule (toxic adenoma) within a multinodular thyroid to a gland with multiple areas of hyperfunction. [emedicine.medscape.com]

prevent tracheomalacia and extubated her after 36 h after performing leak test. [aeronline.org]

Repas is the former chairman of the professional diabetes advisory committees of the Wyoming and the Wisconsin Diabetes Prevention and Control Programs. [healio.com]

The routine use of iodized table salt now helps prevent this deficiency. Risk factors are being female, being older than 40, having an inadequate dietary intake of iodine, living in an endemic area, and having a family history of goiters. [uclahealth.org]

Prevention To prevent toxic nodular goiter, treat hyperthyroidism and simple goiter as your provider suggests. [account.allinahealth.org]

Large goiters occasionally require surgery or iodine-131 to shrink the gland enough to prevent interference with respiration or swallowing or to correct cosmetic problems. Thyroid function is usually normal. [merckmanuals.com]