Glocal Hospital, Krishnanagore, West Bengal, India
A female patient aged about 41 years came to the outpatients’ department of Glocal Hospital, Krishnanagore and West Bengal, India complaining of a massive swelling in front of the neck. A diagnosis of Multi-nodular goiter was made. The normal thyroid gland is usually a homogenous structure. It is an endocrine gland and secretes thyroxin (T4) and small amounts of triiodothronine (T3). Regulation of these two components (T4 and T3) is done by Thyroid stimulating hormone (TSH). TSH is released from the anterior pituitary. The gland has two lobes connected by an isthmus. Excess secretion of thyroxin causes hyperthyroidism and less secretion or no secretion results in hypothyroidism. There can be a single nodule (Figure 1) which may secrete excess thyroid hormone (toxic nodule). Our understanding of the physiology of thyroid hormone and its regulation, treatment with drugs has been developed. The other treatments are radio iodine treatment and surgery.