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What should be done for a multinodular goiter?

waelhammad
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2022-11-18
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• A 42-year-old male with no active medical problem noticed a thyroid nodule 1 year back and was told by ENT specialist not to worry about it. Now he has come as he feels that the nodule is becoming more prominent. 

• Physical examination: 1 × 2 cm right lower pole nodule. There is also a lymph node which is hard and about 2 cm in size in the upper cervical chain in the right lateral neck region. An ultrasound is done which shows features of multinodular goiter. The FNA is done from the lymph node which showed metastatic papillary thyroid cancer. The patient was subjected to total thyroidectomy with radical neck dissection.

What should be done for a multinodular goiter?

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waelhammad
2022-11-18
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Patients with multiple thyroid nodules ≥1 cm should be evaluated in the same fashion as patients with a solitary nodule ≥1 cm, excepting that each nodule that is >1 cm carries an independent risk of malignancy and therefore multiple nodules may require FNA. When multiple nodules ≥1 cm are present, FNA should be performed preferentially based upon nodule sonographic pattern and respective size cutoff.

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