Pediatric Multinodular Goiter

Pediatric Multinodular Goiter

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Summary

A goiter is an abnormal enlargement of the thyroid gland. A multinodular goiter is made up of multiple thyroid nodules.

Causes

The exact cause of multinodular goiter is unknown. Possible contributors may include:

  • Iron deficiency
  • Other thyroid conditions (e.g., thyroiditis, Graves’ disease)

Risk Factors

Multinodular goiter is more common in girls than in boys. Other risk factors may include:

  • A family history of thyroid nodules
  • Previous radiation exposure to the head and neck
  • Age (incidence increases with age)
  • Other thyroid conditions

Symptoms

Many children with multinodular goiter do not have any symptoms, so the goiter is initially discovered during a routine physical exam. For those who do have symptoms, they may include:

  • Difficulty swallowing
  • Difficulty breathing
  • Neck or throat pain
  • Hoarseness
  • Neck Mass / Swelling
  • Unexplained weight loss

Diagnosis

There are several methods that are used for diagnosing multinodular goiter. Your doctor may use a combination of these methods:

  • History and physical exam
  • Blood tests to check thyroid hormone levels
  • Ultrasound (a noninvasive test that uses sound waves to take pictures of the thyroid)
  • Radioactive iodine uptake test (a noninvasive test to determine how much radioactive iodine is absorbed by the thyroid gland over a period of time)
  • Fine needle biopsy (removal of a small amount of thyroid tissue using a thin needle; the tissue is later examined under a microscope.)

Treatment

Treatment for multinodular goiter may include:

  • “Watchful waiting:” monitoring your child’s condition, but no initial treatment
  • Medications to regulate thyroid hormones
  • Radioactive iodine: a liquid that is absorbed into the thyroid and reduces the size and activity of the nodules
  • Surgery to remove the nodules (all or part of the thyroid gland may also need to be removed.)

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