Multinodular Goiter
In multinodular goiter the thyroid contains multiple nodules of varying size. Each nodule is evaluated on its own characteristics rather than treating the gland as a whole.
Multinodular goiter is followed when nodules are benign and there are no pressure symptoms. Surgery is considered for suspicious nodules, pressure, retrosternal extension or hyperthyroidism.
Overview
Multinodular goiter is common, especially in iodine-deficient regions. Each nodule needs its own ultrasound assessment because a dominant nodule may still be benign and a smaller one may be suspicious.
How Each Nodule Is Evaluated
TIRADS scoring drives biopsy choice. Bethesda results then guide whether the plan is observation, repeat biopsy or surgery.
Symptoms
- Visible neck fullness
- Pressure on swallowing
- Breathlessness lying down
- Voice changes
- Symptoms of toxic nodules (palpitations, weight loss)
Diagnosis and Assessment
- Hormone panel
- Neck ultrasound with TIRADS for each nodule
- FNA biopsy for suspicious nodules
- Scintigraphy when toxic features suspected
- CT for retrosternal extension
Treatment Options
- Follow-up if all nodules are low-risk and asymptomatic
- Medical therapy for hormone problems
- Total thyroidectomy in widespread or suspicious disease
When Is Surgery Considered?
- Suspicious biopsy in any nodule
- Pressure symptoms
- Retrosternal extension
- Toxic multinodular goiter
- Rapid growth
Surgical Methods
- Total thyroidectomy is usual because disease is bilateral
- Nerve monitoring
- Parathyroid preservation
Preoperative Preparation
- Hormone optimisation
- Imaging review
- Anaesthetic assessment
- Medication review
Postoperative Follow-up
- Hormone replacement
- Calcium and vitamin D
- Voice rest
- Follow-up with ultrasound and hormone tests
Risks and Safe Surgery
- Voice change
- Low calcium
- Bleeding
- Wound infection
- Scar
Process in Antalya
Bring your ultrasound, biopsies and CT if performed to the consultation; any plan for surgery is made in Antalya after examination.
When to Seek Urgent Care
- • Sudden breathing difficulty
- • Acute, severe neck swelling
- • Severe palpitations in toxic goiter
Frequently Asked Questions
Related Pages
Appointments and Directions
WhatsApp and email are for administrative matters such as appointments and directions only. Please do not send health data or medical documents (ultrasound, biopsy/pathology, blood tests, images, reports, prescriptions, symptom summaries or ID documents); no diagnosis, treatment advice or pre-assessment is given by message. In an emergency call 112 (in Türkiye) or your local emergency number, or go to the nearest emergency department.
This information is provided for general patient education only and does not replace diagnosis, treatment or a surgical decision. Personal evaluation requires a clinical examination and the necessary tests.
Content update date: 24 September 2026 · Responsible for content: Op.Dr.Gökhan ATEŞ · atesdr@yahoo.com
Thyroid & Goiter Surgery Antalya · Özel Antalya Medicalpark Hastanesi