Author(s): Suganakar Kodi1, Sudhakar Waddi2, Sai Krishna Katakam3, Deepika P4
Multinodular goitre (MNG) is the most common thyroid disease in the world with more than 300 million people estimated to be affected. MNG is the result of aberrant growth of thyroid follicular cells following chronic TSH stimulation, which, via hyperplasia, leads to the nodular degeneration of thyroid tissue.
500 patients presenting with MNG without obvious evidence of malignancy were studied, out of them 58 cases were toxic MNG. All patients presented with palpable neck swelling, were evaluated in terms of history, clinical examination and subjected for relevant investigations, taken up for surgery with prior thyroid profile, USG neck, FNAC and histopathology of resected specimen done postoperatively.
Toxic MNG constituted 11% of MNG. Toxic MNG is more common in females (female to male ratio is 5:1) and majority are in the age group of 41-50 years (48%). In majority (90%) of patients, duration of the swelling prior to the presentation was 2-5 years.
Total thyroidectomy is the surgery of choice for toxic MNG. Surgical therapy has major advantage of rapid control of thyrotoxicosis, minimise the cardiac effects of coexisting severe cardiotoxicity.