[Goiter]

Abstract

Studies in Switzerland (1979), in Austria (1982) and in Germany (1975) revealed that greater than 10% of the population has a goiter. Simple guidelines are offered to the practising physician for the work-up and therapy of this fairly common pathological condition. In the work-up one investigates firstly whether the goiter in question could be malignant, and, secondly, whether it could be due to thyroiditis. If this is not the case the goiter is probably benign (Graves' goiter or "simple" goiter). Malignant goiters are referred to the endocrinologist/surgeon for further work-up and therapy. Subacute thyroiditis is treated with salicylates or steroids. The hyperthyroid phase of thyroiditis is treated with beta-blockers and possibly steroids and the hypothyroid phase with thyroxine. The hypo- and euthyroid variants of "simple" goiter are treated with thyroxine. Goiters which grow during this therapy are removed surgically. The hyperthyroid variant of "simple" goiter should preferably be treated surgically.