25/08/2022
1. Enlarged thyroid
Mick, MD, Department of Endocrinology - Diabetes, Tam Anh General Hospital in Ho Chi Minh City said: 80% of thyroid goiters are benign goiters (medically called simple goiter or aneurysm). The disease presents with swelling of the thyroid gland, with an abnormally enlarged thyroid gland.
There are many causes of benign goiter such as: iodine deficiency diet; female hormone disorders in puberty, pregnancy, childbirth, perimenopause; due to antithyroid substances; abnormalities in thyroid hormone synthesis; persistent diarrhea; nephrotic,…. (first)
This disease is more common in women than men. Benign goiter also occurs silently and is difficult to detect in the early stages. The disease only appears as a large tumor without changing the hormone secreting function of the thyroid gland.
When the disease progresses along with the growth of the tumor, the patient will easily notice signs such as: Feel a tumor in the middle of the neck, have clear boundaries, do not stick to the skin, no pain, move in rhythm swallowing, when the goiter is large, it can cause uncomfortable compression.
2. Nodular goiter
Nodular goiter has a benign mononodular or multinodular form (multinodular goiter), patients will see many round masses from 0.5 cm to a few cm in diameter around the neck. At this time, the patient has a feeling of shortness of breath due to the pressure of the tumor, even difficulty speaking, hoarseness, double voice, ... when compressing the nerve. The patient had facial edema, neck edema, and chest distension due to the tumor compressing the vena cava.
Goiter is a benign disease that resolves on its own in some patients. When the tumor has nuclei, the most optimal method of treatment is to use surgery. The earlier the disease is detected, the more effective the surgery is.
For patients with thyroid enlargement or nodular goiter, there is compression in the neck depending on the size and location of the goiter. Among people with goiter, 5% to 10% of cases are malignant.
3. Thyroid cancer
Thyroid cancer occurs in 5% -10% of patients with thyroid core. The reason is due to the abnormal division of thyroid cells. Two types of cancer include papillary cancer and cyst cancer accounting for about 90% of thyroid cancer. However, the initial signs like normal goiter should be easily overlooked.
If thyroid cancer is detected, surgery should be performed early. At this time, ultrasound will show the manifestations of solid nuclei, lymph nodes, calcifications, lymph nodes, etc. If in doubt, a fine-needle biopsy (FNA) will be performed.
Treatment of thyroid cancer by radiotherapy with radioactive iodine. Laparoscopic or open surgery.
4. Hyperthyroidism
Hyperthyroidism occurs when the thyroid gland produces too much hormone. This excess can have a number of causes, including thyroiditis or Graves' disease (diffuse toxic goiter). (3)
When hyperthyroidism occurs, it can cause a variety of symptoms, including: Fast or irregular heartbeat; difficulty sleeping; irritability and anxiety; tired; hot; frequent bowel movements/diarrhea; thin weight loss, enlarged thyroid (big neck).
If left untreated, Graves' disease can cause severe thyrotoxicosis. A life-threatening thyrotoxicosis crisis (thyroid storm) may occur. Prolonged severe thyrotoxicosis leads to severe weight loss with bone and muscle catabolism. Cardiac complications and psychiatric complications can cause significant morbidity. Graves' disease is also associated with eye, skin, and white blood cell problems.
Thyroid storm is an exaggerated state of thyrotoxicosis, which usually occurs in patients with undetected or inadequately treated thyrotoxicosis or a precipitating event such as thyroid surgery, surgery without thyroid, infection or injury. When thyroid storm was first described, the acute mortality rate was close to 100%. But so far, with aggressive therapy and early recognition of the syndrome, the mortality rate is only 20%.
Treatment methods for hyperthyroidism include: Medical treatment with drugs, radiation therapy by taking radioactive iodine or surgical treatment by thyroid surgery.
The opposite of hyperthyroidism is hypothyroidism. It occurs when the thyroid gland does not produce enough hormones for the body. This is the most common thyroid disorder, which can cause processes in the body to slow down. Symptoms of hypothyroidism include: Fatigue, fear of cold, dry skin, slow heart rate, cramps, constipation, weight gain, etc.
Treatment is usually thyroid hormone supplements to control symptoms. However, if not treated early, it will cause cardiovascular effects, infertility.
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