bocios

Bocio, in medical Spanish, refers to goiter, the enlargement of the thyroid gland. The term bocio is used for the condition itself rather than a specific disease, and bocios (the plural) describe thyroid enlargements of various causes. It is commonly associated with iodine deficiency but can occur with other thyroid disorders. Goiter can be diffuse, where the entire gland enlarges, or nodular, where one or more nodules are present. It may be non-toxic, with normal thyroid function, or toxic, associated with hyperthyroidism.

Causes and types include endemic goiter, seen in populations with prolonged iodine deficiency, and sporadic goiter, which can arise from nodular thyroid disease, autoimmune thyroiditis, or other conditions. Toxic goiters involve excess thyroid hormone production. Pregnancy and certain medications can influence thyroid size and function. The presentation ranges from a noticeable neck swelling to compressive symptoms in large goiters, such as coughing, difficulty swallowing, or breathing problems, though many goiters are asymptomatic.

Diagnosis is based on clinical examination and thyroid function tests (TSH and free T4), supplemented by thyroid antibodies when autoimmune disease is suspected. Imaging, especially neck ultrasound, helps assess size, structure, and nodules. Fine-needle aspiration biopsy may be performed if nodules raise concern for cancer. In selected cases, radioiodine scans or other imaging are used to evaluate function and anatomy.

Treatment depends on cause, size, symptoms, and cancer risk. Iodine supplementation or iodized salt addresses iodine deficiency. Mild non-toxic goiters may be observed, while hyperthyroid goiters require antithyroid medications, radioactive iodine, or surgery. Large or obstructive goiters often require surgical removal. Prevention focuses on ensuring adequate iodine intake through dietary sources or public health measures.