Strúma

Strúma is a medical term used to describe enlargement of the thyroid gland, commonly referred to in English as goiter. The term may denote a diffuse thyroid enlargement or a nodular goiter. In several languages, including those with diacritical marks, strúma serves as the local word for this condition. The word derives from Latin struma, which in turn has roots in Greek.

Causes of strúma include iodine deficiency, which remains a leading worldwide cause, as well as autoimmune thyroid diseases such as Hashimoto's thyroiditis and Graves' disease. Nodular thyroid disease, benign or malignant thyroid nodules, and, less frequently, thyroid cancer or inflammatory conditions can also lead to goiter. The functional status of the thyroid may be normal, hyperactive, or underactive in different cases.

Symptoms vary with size and thyroid function. Some individuals notice a visible or palpable neck swelling; larger goiters can cause pressure, coughing, or trouble swallowing or breathing. Hyperthyroid goiters may produce symptoms such as weight loss, palpitations, and anxiety, while hypothyroid goiters can cause fatigue, weight gain, and cold intolerance. Many goiters are asymptomatic.

Diagnosis involves clinical examination supported by thyroid function tests (TSH and free T4), ultrasound imaging, and evaluation of iodine status. Additional tests, such as radioactive iodine uptake or fine-needle aspiration biopsy, may be used to assess nodules or rule out cancer.

Treatment depends on cause, size, and symptoms. Small, asymptomatic goiters may be observed, while iodine supplementation is used in deficient regions. Hyperthyroid goiters may require antithyroid drugs or radioactive iodine; hypothyroid goiters need thyroid hormone replacement. Large or suspicious goiters are often managed by surgery.