Struma

Struma is a medical term for enlargement of the thyroid gland, commonly referred to as a goiter. The word derives from Latin and Greek roots meaning swelling or lump in the throat. Struma describes any thyroid enlargement, regardless of whether the gland is producing normal, excessive, or reduced amounts of thyroid hormone.

Goiters can be diffuse or nodular and may be endemic or sporadic. Major causes include iodine deficiency, autoimmune thyroid diseases such as Hashimoto’s thyroiditis or Graves’ disease, nodular thyroid disease, and less commonly thyroiditis or thyroid cancer. Endemic goiter occurs in regions with low iodine intake, a problem historically common but reduced by iodized salt programs.

Symptoms depend on the size and location of the enlargement and may include a visible neck lump, a sensation of tightness, or cosmetic concerns. Large goiters can cause difficulty swallowing or breathing and may affect voice. Thyroid function can be normal (euthyroid), overactive (toxic goiter or hyperthyroidism), or underactive (hypothyroidism). Evaluation typically involves a physical examination, thyroid function tests, neck ultrasound, and fine-needle aspiration biopsy if nodules are present.

Treatment is guided by cause and symptoms. Small, asymptomatic goiters with normal function may simply be monitored. Iodine supplementation or thyroid hormone therapy can reduce enlargement in certain iodine-deficient scenarios. Toxic goiters may be treated with antithyroid medications or radioactive iodine; large goiters causing compression or with suspicious nodules may require surgical removal. The prognosis is generally favorable with appropriate management.