12. Goiter
The term goiter describes a condition wherein there is an increase in the size of the thyroid gland. According to its characteristics, goiter can be diffuse, that is, at the expense of a global and regular increase of the gland; or nodular, in which there are focal increases in thyroid size. Although a high percentage of goiters are present without any apparent alteration in thyroid hormones, many times, they are due to the formation of cystic, hemorrhagic or solid nodules as a result of the focal proliferation of thyroid tissue. When there are enzymatic deficiencies in the synthesis of thyroid hormones, an increase in TSH can lead to an increase in glandular size. Therefore, many cases of Hyperthyroidism present with goiter because in order to produce an increased level of thyroid hormones, it is necessary that the gland be larger and have a greater synthetic capacity.