What is a Goiter?
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
January 17, 2012
In the Philippines, particularly, in the Filipino- or Tagalog-speaking community, the words “goiter” and the Filipino-word “bosyo” are commonly used. “Goiter” and “bosyo” are being used to refer to the same thing, that is, that something is wrong with the thyroid gland.
Thus, the human organ involved in a goiter is the thyroid gland which is located in the central part of the neck.
What really is a goiter?
In the literature and Internet, one will see numerous articles on the meaning of goiter. The definitions vary and are conflicting with each other.
Historically, the origin of the word “goiter” dated as far back as 17th century (1620s), from French “goitre” and from Latin “guttur” which all mean “throat.” (http://www.thefreedictionary.com/goiter)
For one reason or another, over the years, goiter eventually refers to a condition in the thyroid gland and not just the “throat” anymore.
Most of the articles in the literature would define “goiter” as an abnormal enlargement of the thyroid gland, with emphasis it is not a cancer, and some would say, it is not due to an inflammatory process. The predominant thinking is that the abnormal enlargement of the thyroid gland is due to an underproduction or overproduction of thyroid hormones or due to a deficiency of iodine in the diet. Note: International Classification of Diseases 10th edition carries this philosophy.
Over the years, however, the traditional concept of goiter being a response to any factor that impairs thyroid hormone synthesis has been modified to include a variety of clinical, functional, and morphologic presentations. A goiter is now considered to be any disorder of the thyroid gland that can be due to any and all possible causes. It can be due to hyperthyroidism or hypothyroidism. The thyroid enlargement, that is the goiter, may be diffuse or nodular in configuration. The goitrous thyroid may have nodules which may be cancerous (malignant) or noncancerous (benign). It may also be due to thyroiditis or inflammation of the thyroid gland.
In summary, goiter is any form of enlargement of the thyroid gland that can be due to any kind of thyroid disorders.
The word “goiter” really is not a very descriptive term.
Dr. R. Anders Rosendahl
The word “goiter” has been around for a long, long time. I remember as a child reading about the iodine deficiency in some regions of America where people developed huge thyroid glands as a result of that lack of iodine. These were called goiters. Some patients in my office bring up an episode of the TV show Seinfeld, where an elderly lady had a very large and deforming “goiter” that was embarrassing to those around her.
The problem I find with the word “goiter” is that it really isn’t a very descriptive term. Often times a colleague will call me up and say he has a patient he would like me to see and the patient has a goiter. I have no idea what that means. The diagnostic possibilities here are enormous. On the other hand, if my colleague calls me up and says he has a patient with a 3 centimeter in diameter mass which is very firm, located in the upper portion of the right lobe of the thyroid gland, then I have a really good idea about the patient’s problem.
The medical dictionary defines “goiter” as “an enlargement of the thyroid”. This is just not descriptive and therefore not helpful. I have a saying that I came up with many years ago about this subject, and it goes like this: “Because the word goiter means so many different things to so many people, it really means nothing to anybody.” That is my tongue in cheek way of asking doctors and patients alike to describe the thyroid enlargement in detail so that I may get a feel for what the thyroid problem really is.
It is said that we should choose our battles in life, and, frankly, I don’t think I’m going to win this one. The word ‘goiter’ is probably going to still be in use long after I retire from the practice of thyroid surgery.
ROJoson’s Notes: Very true also in the Philippines and I agree with the sentiments of Dr. Rosendahl.