How many types of goiter are there?

The article was professionally consulted with Master, Doctor Do Xuan Chien - Head of Department of Medical Examination & Internal Medicine - Vinmec Ha Long International General Hospital.

Goiter is a disease of the thyroid gland, which is an endocrine gland located in the front, lower part of the neck, pressing on the lateral surfaces of the larynx and the first rings of the trachea.
Goiter has 3 main types as follows:

1.1. What is a simple goiter? Simple goiter (popularly called benign goiter) is the most common goiter, accounting for 80%. This is a swelling of the thyroid gland that is not caused by cancer or inflammation, and there are no signs of an overactive or underactive thyroid. The disease is more common in women than men. Simple goiter is usually euthyroid (no thyroid hormone changes).
1.2. Causes of simple goiter: Simple goiter is often caused by many different causes including: iodine deficiency (main cause), female hormone disorders occurring in girls at puberty, women pregnancy, premenopausal women, due to antithyroid substances (found in white cabbage, antithyroid drugs in cassava, due to abnormalities in thyroid hormone synthesis, iodine loss due to prolonged diarrhea, syndrome) kidney failure ...
1.3 Identify simple goiter Simple goiter manifests in two forms:
Diffuse goiter (large thyroid gland evenly out)
Nodular goiter (with one or more nodules).
Cases of simple goiter (also known as benign mononuclear goiter): the patient will find a tumor in the middle of the neck, palpable with clear boundaries, not attached to the skin, painless, soft. or firm, moving according to the rhythm of swallowing up and down, when the tumor is large, it can cause compression.In the case of simple multinodular goiter (also known as benign multinodular goiter), the patient finds many round masses. glass from 0. 5 to several centimeters in the neck area. A simple goiter is often discreet, has no obvious symptoms, is painless, and is often discovered incidentally during a general physical examination. When a goiter grows to a large size, it can cause signs of compression of surrounding organs and organizations such as:
Compression of the trachea causing difficulty breathing Compression of the recurrent nerve causing difficulty speaking, hoarseness, speech two voices Compression of the superior vena cava causes coat-shaped edema including edema of the face, neck, thorax, and arms with collateral circulation in the chest.

1.4. Does simple goiter need surgery? With simple goiter with diffuse thyroid enlargement (distributed goiter), patients only need to be treated with drugs to give very good results. Particularly for single-nodular goiter or multinodular goiter (benign): if drug treatment is not effective for 6 months, surgery must be performed. Usually, patients detect tumors early, go to the doctor immediately, they will have better results because if left for a long time: around the nucleus there will be a fibrous area that does not respond to drugs. In addition, some patients with nodular goiter will have to have surgery soon, even though medical treatment (with drugs) has not been completed, when the goiter has complications that cause compression, difficulty breathing, rapid growth, internal hemorrhagic goiter. goiter or elderly patient with hoarseness does not exclude cancer. Special attention should be paid to girls in puberty (12-18 years old) or pregnant women with slightly enlarged thyroid gland, diffuse aneurysm. Radical is a physiological phenomenon, absolutely no indication for surgery.

Hyperthyroid goiter, also known as hyperthyroidism, is common in women between the ages of 20 and 45. Hyperthyroid goiter is a disease of the thyroid gland, in which thyroid hormone is overproduced normally. .
The most common cause is Graves disease with diffuse goiter with or without protrusion, the rest are hyperthyroidism with toxic multinodular goiter. Regardless of the cause, the common manifestations of hyperthyroidism are hyperthyroidism syndromes: tremors, rapid heart rate, nervousness, eating a lot but being thin (some patients lose 10 kg in three months) and often abnormally short-tempered. .
For hyperthyroid goiter, treatment is mainly with synthetic antithyroid drugs, cardiovascular drugs. The patient will recover quickly and return to a normal state. Duration of treatment is about 12-18 months, usually giving very good results for hyperthyroidism where the goiter is diffuse grade 1 or the thyroid gland is still in normal size. However, for hyperthyroidism with nodular goiter or large thyroid gland of grade 2 or 3, after medical treatment is stable (gain weight, stop shaking hands, stop palpitations, heart beat normally, pulse stops fast). ) should be combined with surgery for better treatment results.

Symptoms of thyroid cancer (malignant goiter) at an early stage are similar to those of a simple goiter (benign goiter). The disease is common in middle-aged and elderly people, in the group of patients with mononuclear goiter. However, in patients with hyperthyroidism, multinodular goiter and diffuse goiter... there is also a small percentage of thyroid cancer. At the late stage, the patient has symptoms of irreversible hoarseness.
With goiter in thyroid cancer, the treatment direction is to remove all cancerous thyroid lobes, cut the isthmus, and remove lymph nodes. If nodal metastases are present, remove both lobes, lymph node dissection, accept hypothyroidism and lifelong supportive therapy with thyroid hormone.