Goitre and thyroid cancer

Goitre is the generic term for thyroid enlargement and encompasses relatively common benign disease as well as thyroid malignancy, which is uncommon. Unfortunately, the clinical presentations of benign and malignant thyroid disease are similar. The aim of clinical assessment and investigations is to identify the small number of cancers among the frequent non-malignant thyroid enlargements. Investigations include thyroid function tests and fine needle aspiration cytology. Benign thyroid disease requires treatment only in the presence of dysfunction or local compressive symptoms. The treatment of thyroid cancer is multidisciplinary and includes surgery, radioiodine therapy and life-long suppression of thyroid-stimulating hormone. The diagnosis and management of thyroid cancer are being centralized around a multidisciplinary team structure in order to improve outcomes in the UK. Recent developments in the management of thyroid cancer include the use of molecular biomarkers to identify malignancy in thyroid nodules and targeted therapy for advanced disease.