[Neck tumors: struma].

Goiters are most commonly caused by increased, usually nodular growth of thyroid tissue ('simple' goiter), stimulation of thyroid growth by autoantibodies (Grave's disease) or thyroiditis. Rarer causes of goiter are malignant thyroid tumors and hereditary disturbances of thyroid hormone synthesis goiter: due to iodine deficiency should be found no longer in Switzerland because of the adequate iodine supplementation in this country. Differentiating the various types of goiters is usually possible on the basis of clinical signs and a few laboratory tests (e.g. measurement of thyroid antibodies). 'Simple' goiter is usually treated surgically. Hyperthyroid Grave's goiter is primarily treated with thyrostatic drugs, if it recurs; radioiodine of surgery are also used. Subacute thyroiditis causing goiter is treated symptomatically with analgesics anti-inflammatory drugs, while patients with chronic thyroiditis are given thyroid hormones when hypothyroidism occurs. Malignant tumors of the thyroid are treated surgically; in some cases additional therapy with radioiodine is indicated.