Goiter is a dramatic enlargement of the thyroid gland. In the past goiter was common due to a lack of iodine in the diet. A more common cause of goiter today is an increase in thyroid stimulating hormone (TSH) in response to a defect in normal hormone synthesis within the thyroid gland.

Risk factors for the development of a goiter include female sex, age over 40 years, inadequate dietary intake of iodine, living in an endemic area, and a family history of goiter.

Small to moderate sized goiters can be treated by providing pills with thyroid hormone. By supplying thyroid hormone in this fashion, the pituitary will make less TSH which should result in stabilization in size of the gland. Patients who do not respond to thyroid hormone therapy are often referred for surgery if it continues to grow.

Large goiters are often removed because of cosmetic reasons or, more commonly, because they compress other vital structures of the neck, including the trachea and the esophagus making breathing and swallowing difficult.

The surgery is made under anesthesia. An incision is made along the skin lines in the neck, than the surgeon remove all or part of the thyroid gland. Some normal thyroid tissue may be left in place. Surrounding tissue is then returned to its normal position and the incision is closed.

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