Goiter

Last revised by Candace Makeda Moore on 5 Jan 2025

Goiter (rarely thyromegaly) refers to enlargement of the thyroid gland. It can occur from multiple conditions, including iodine deficiency, hormonal dyscrasias, and infectious/inflammatory conditions. The absence of thyroid enlargement does not preclude significant thyroid pathology.

The definition of goiter depends on age and sex. The upper limit of normal thyroid gland volume:

  • adult males: 12-18 mL 9

  • adult females: 10-15 mL 9

  • 13-14 years: 8-10 mL 1

  • 3-4 years: 3 mL 1

  • neonate: 0.8-1.5 mL 1

The prevalence of goiter varies widely depending on the level of iodine deficiency. In severely iodine-deficient areas the prevalence may be as high as 80%. Goiter is more common in women, and incidence declines with age 5.

The thyroid gland may become so enlarged that it becomes a substernal (retrosternal) goiter.

The causes of goiter are diverse 2,3:

  • each lobe normally measures 4,9:

    • length: 4-7 cm

    • depth: 1.3-2 cm

    • isthmus ≤0.5 cm deep

Thyroid volume can be estimated by measuring each lobe and applying the following correction factor for an ellipsoid formula 6:

  • height (cm) x width (cm) x depth (cm) x 0.529*

* various correction factors between 0.494-0.554 have been proposed 6,9

Goiter derives from the old French "goitron" meaning gullet. Goitron comes from the Latin "guttur" meaning throat.

See main article: midline neck mass

Cases and figures

  • Case 1: multinodular goiter
  • Case 2: nodular Graves' disease
  • Case 3: Hashimoto thyroiditis
  • Case 5
  • Case 6
  • Case 7: retrosternal
  • Case 8
  • Case 9: retrosternal goiter
  • Case 10: due to thyroid lymphoma
  • Case 11: severe tracheal narrowing and deviation
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