Surgery for Intrathoracic (Retrosternal) Goitres

MNG refers to an enlarged thyroid gland with multiple nodules. Challenges specific to MNG include evaluating the patient, determining the risk of malignancy within the multiple nodules, selecting patients who require surgery, and planning an appropriate surgical approach to address the disease without undue risk of complications. MNG is generally presumed to be a response to oversecretion of Thyroid Stimulating Hormone (TSH). The thyroid hyperplasia is probably due to reduced production of thyroid hormones relative to the metabolic demand of the body. This can be due to a congenital or an acquired defect. Morphological and molecular studies suggest a degree of polyclonal aetiology. MNGs are sometimes familial and one study suggests linkage to a DNA mother as chromosome 14q 2.

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