Symptoms develop insidiously and are related chiefly to compression of adjacent structures, including the trachea, esophagus, and recurrent laryngeal nerves. Constitutional evidence of inflammation is uncommon. The thyroid gland is moderately enlarged, stony hard, and usually asymmetrical. The consistency of the gland and the invasion of adjacent structures suggest carcinoma, but there is no enlargement of regional lymph nodes. Temperature, pulse, and leukocyte count are normal.
Hypothyroidism is unusual.
The RAIU may be normal or low. Circulating thyroid autoantibodies are less frequent and are found in lower titers than in Surgery may be required to preserve tracheal and If extensive involvement of perithyroid tissues is present, resection of the isthmus may relieve some symptoms.