Published 13 July 2009, doi:10.1136/bmj.b2563
Cite this as: BMJ 2009;339:b2563

Practice

10-Minute Consultation

Thyroid swellings

Rebecca Hatton, clinical research associate1, Madhukar Patel, general practitioner2, Devasenan Devendra, community consultant endocrinologist and honorary senior lecturer in medicine3

1 Central Middlesex Hospital, London NW10 7NS, 2 Brent Teaching Primary Care Trust, London HA0 4UZ, 3 Brent Teaching Primary Care Trust; Central Middlesex Hospital; and Division of Investigative Science, Imperial College, London W12 0NN

Correspondence to: D Devendra d.devendra@imperial.ac.uk

The first 150 words of the full text of this article appear below.

A 48 year old post-menopausal woman presents with a smooth midline swelling in her neck, which has been present for more than 10 years. On examination, you find that it is consistent with an enlarged thyroid gland.

  • A palpable thyroid swelling (defined as a goitre) may be physiological if the patient is pregnant or going through puberty.
  • Patients who have lived in an iodine deficient area (for example, north Pakistan, central Africa, and mountainous areas such as the Andes or Himalayas) are at increased risk of goitre.
  • Lithium, amiodarone and antithyroid drugs (such as carbimazole and propylthiouracil) can predispose to goitre.
  • Thyroid swellings are more likely to be malignant in patients over 65 years or in women during their reproductive years.
  • Common differentials for swellings in the central component of the neck include thyroglossal cysts (which move on tongue protrusion), dermoid cysts (easily moved under the skin), lipomas, and sebaceous . . . [Full text of this article]

For professionals
For patients

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