We present a rare case of a giant substernal nontoxic goiter which caused acute respiratory failure which was treated by urgent thyroidectomy through a T-incision. [ncbi.nlm.nih.gov]

ICD Code ICD Description Total National Projected Hospitalizations - Annualized (Present on Admission - All) Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) Total National Projected Hospitalizations - Annualized (Present [dexur.com]

About 10% of these patients require emergency airway intubation (4), as in the present case. [scielo.br]

• Goiter

  The disappearance curves of Tg in both groups had two exponentials, an initial steep slope with a half-life of 4.0 /- 1.8 (SD) h in nontoxic goiter and 4.5 /- 3.2 h in toxic goiter. [ncbi.nlm.nih.gov]

• Laboratory Technician

  § Laboratory technician, Radioactivity Research Center, University of California Medical Center. [nejm.org]

• Multiple Organ Dysfunction Syndrome

  The patient was once again placed under inotropic support with noradrenaline but deteriorated day-by-day and developed multiple organ dysfunction syndrome due to sepsis. The patient died on the 17th postoperative day. [scielo.br]

• Inspiratory Stridor

  stridor • Dyspnea • Dysphagia • Symmetrically enlarged thyroid with smooth surface, or enlarged thyroid with multiple nodules • Enlargement and prominence of the large veins of the neck and upper thorax • Thyroid function tests usually normal • Thyroid-stimulating [accesssurgery.mhmedical.com]

  Patients who have symptoms and signs of tracheal compression (inspiratory stridor and dyspnea) should have radiographs taken of the trachea or CT or MR imaging of the neck and upper thorax. [journals.lww.com]

• Muscle Tenderness

  The changes do not seem to cause more neck pain, muscle tenderness or degeneration of the cervical spine. [ncbi.nlm.nih.gov]

• Neck Swelling

  Symptomatic patient may present with painless neck swelling, cosmetic complaints, shortness of breath, sudden increase in goiter size with pain due to hemorrhage, larger goiter causing obstructive signs eg dysphagia, choking sensation and Pemberton's [specialty.mims.com]

  On physical examination, there will be a central neck swelling that could be smooth or nodular and the mass moves with swallowing. It may deviate the trachea or extend retrosternally. [statpearls.com]

Any cervical lymphadenopathy should suggest malignancy: a workup is warranted. Vocal cords must be examined in cases of hoarseness or before and surgical intervention. [statpearls.com]

cervical lymph nodes) in malignant infiltration References:[1][2] Diagnostics Best initial step: palpation of thyroid gland (see “Classification of goiter by palpation” below) Laboratory tests Initial workup: TSH levels Possible screen for thyroid [amboss.com]

Three months after thyroidectomy, patients were randomized to L-T4 treatment (group A, n 100) with an initial dose of 150 microg daily and to no treatment (group B, n 102). [ncbi.nlm.nih.gov]

Prognosis A non-toxic goiter is a benign entity and only causes aesthetic problems. However, if the size is large, it may compress the trachea, laryngeal nerves, and the esophagus. Most benign goiters have an excellent prognosis. [statpearls.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Etiology is usually unknown. Some known causes include iodine deficiency, iodine excess, goitrogen ingestion, autoimmune disorders, thyroid hormone production defects and certain medications. It is usually asymptomatic. [specialty.mims.com]

However, the true etiology of most nontoxic goiters in iodine-sufficient areas is unknown. [msdmanuals.com]

Goitrous enlargement may result from various etiologies: stimulation from elevated TSH levels as seen in iodine deficiency and Hashimoto disease, TSH-receptor antibodies/agonists as in Graves disease, or unclear etiology such as in nontoxic multinodular [ime.acponline.org]

Race No convincing epidemiologic studies suggest that race plays an important role in the development of nontoxic goiter. [emedicine.medscape.com]

Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. Wolters Kluwer-Medknow Publications. 2011;15(2):S78-81. Usha Menon V, Sundaram KR, Unnikrishnan AG, Jayakumar R V, Nair V, Kumar H. [ijsurgery.com]

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

Long-term studies are needed to define the effects of thyroid hormone suppressive therapy on the growth of goitrous lesions based on their underlying pathophysiology. [ncbi.nlm.nih.gov]

Features of MyAccess include: Remote Access Favorites Save figures into PowerPoint Download tables as PDFsGo to My Dashboard Close • May be a diffuse or a multinodular goiter • May be physiologic or pathophysiologic -Physiologic occurs during puberty, [accesssurgery.mhmedical.com]

There is no racial relation to the prevalence of goiter. [5][2] Pathophysiology The deficiency of iodine or increasing demands for thyroid hormones leads to pituitary gland stimulation that increases TSH secretion. [statpearls.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]

Some, but not all, series suggest that postoperative use of thyroid hormone suppressive therapy prevents recurrence of benign goiter. [ncbi.nlm.nih.gov]

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. [msdmanuals.com]

Table salt has been supplemented in the United States since the 1920s for the prevention of cretinism and endemic goiter. [emedicine.medscape.com]