Multinodular Goiter BT - Endocrine Surgery: Principles and Practice

Abstract

Goiter is a general definition of any enlargement of the thyroid gland; multinodular goiter is the name given where multiple nodular enlargements have developed within the thyroid gland. David Marine was the first to postulate the formation of multinodular goiter, which is caused by inadequate production of thyroid hormones coupled with the increase in thyroid-stimulating hormone (TSH) response. This led to the initial phase of hyperplastic changes in the thyroid gland. Subsequently, when there is iodide repletion or decreased requirement of thyroid hormone, the thyroid gland responded into a resting phase of colloid storage. It is the repetition of these two phases of the cycle that would eventually lead to formation of multinodular goiter [1]. Selwyn Taylor supported this concept and believed that the initial formation is diffuse thyroid hyperplasia, but with time discrete nodules develop [2].