Nodular Goiter 101: How does one get a goiter?
- Iodine deficiency in some countries, Low level TSH stimulation and goitrogens in environment cause the first step.
- Hyperplasia, and hypertrophy forms in the early Diffuse Goiter stage.
- Further TSH stimulation along with somatic mutations leads to follicular cell proliferation and the first sign of nodule formation.
- Nodules do not produce hyperthyroidism in early phase.
- Simple goiter is a condition at first which has normal thyroid blood tests.
- Continuing proliferation is associated with the appearance of activating mutations of the TSH receptor.
- This leads to thyroid gland autonomy and eventually toxic nodular goiter in some cases of conversion from simple goiter.
- Further gland growth results in compressive symptoms and degenerative changes such as cyst formation, hemorrhage, calcification, and Hurthle cell metaplasia, not Hurthle cell neoplasms.
9. Simple goiter is not so simple as it seems but short of cancer in a goiter there are non-surgical alternatives to treat your enlarging nodular goiter.
10. If you have a large symptomatic benign solid nodule in a goiter there is thyroid radiofrequency ablation RFA therapy available to you now.
11. Italy and Korea have world class Thyroid RFA treatment centers available to my patients after my evaluation. You will not need a new evaluation ,but just spend 2-3 days to be treated and you can return home.
JH Baek in Seoul Korea or Roberto Valcavi in Italy
Asan Medical Center in Seoul and CentroPalmer Institute in Italy
12.If it is a big thyroid or parathyroid cyst we treat those also without surgery with ethanol ablation PEI.
13. Call Matthew at 1310-3938860 for details about the evaluation needed for both procedures.
Richard Guttler MD.FACE,ECNU