Differential Diagnosis for Thyroid Goitre and Dysphagia
Single Most Likely Diagnosis
- Multinodular Goitre: This condition is characterized by the presence of multiple nodules within the thyroid gland, which can cause enlargement of the gland (goitre) and potentially lead to dysphagia due to compression of the esophagus. The likelihood of this diagnosis is high because multinodular goitres are common and can grow large enough to cause symptoms like dysphagia.
Other Likely Diagnoses
- Thyroid Cancer: Although less common than benign thyroid conditions, thyroid cancer (such as papillary, follicular, or medullary thyroid carcinoma) can present with a goitre and cause dysphagia if the tumor grows large enough to compress the esophagus.
- Subacute Thyroiditis: This inflammatory condition of the thyroid gland can cause goitre and, in some cases, dysphagia due to pain and swelling of the thyroid gland.
- Hashimoto's Thyroiditis: An autoimmune condition that can lead to thyroid gland inflammation and enlargement, potentially causing dysphagia, though this is less common.
Do Not Miss Diagnoses
- Mediastinal Mass: Although not directly related to the thyroid, a mediastinal mass (such as a lymphoma or thymoma) can compress both the trachea and esophagus, leading to symptoms of dysphagia and potentially mimicking a thyroid goitre on physical examination.
- Esophageal Cancer: This is a critical diagnosis not to miss, as it can present with dysphagia and, in rare cases, a mass effect that might be mistaken for a thyroid goitre.
- Retrosternal Goitre: A goitre that extends behind the sternum can cause significant compression of the trachea and esophagus, leading to severe dysphagia and respiratory symptoms.
Rare Diagnoses
- Riedel's Thyroiditis: A rare form of chronic thyroiditis characterized by a hard, fibrous thyroid gland that can cause compression of adjacent structures, including the esophagus, leading to dysphagia.
- Anaplastic Thyroid Cancer: A very aggressive and rare form of thyroid cancer that can grow rapidly and cause significant symptoms, including dysphagia, due to its invasive nature.
- Ectopic Thyroid Tissue: Rarely, thyroid tissue can be found in abnormal locations (such as the tongue, neck, or even within the thorax), and if this tissue grows, it could potentially cause dysphagia.