Unlike a thyroid nodule, which is a growth within the thyroid, a goiter is an enlargement of the thyroid itself. When the thyroid becomes enlarged, pressure on the trachea and esophagus make swallowing and breathing uncomfortable or difficult. Larger goiters are visible from the exterior, as a lump or swelling of the neck.
A goiter can develop due to a deficiency of iodine (this is now rare in developed countries, due to the prevalence of iodized table salt) or as a symptom of certain autoimmune diseases. Treatment depends on the size of the goiter, and if it is putting pressure on the structures inside and causing symptoms. A goiter that is not visibly enlarged, does not have a suspicious nodule within it, and is not causing symptoms does not require surgical removal.
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Next, read about thyroid cancer.