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III. Medical Department, University of Leipzig Ph.-Rosenthal-Str. 27, D-04103 Leipzig, Germany; Interdisciplinary Center for Clinical Research Leipzig, University of Leipzig Inselstraße 22, D-04103 Leipzig, Germany
* To whom correspondence should be addressed. E-mail: pasr{at}medizin.uni-leipzig.de.
The purpose of this review is to summarize the current knowledge of the etiology of euthyroid and toxic multinodular goiter with respect to the epidemiology, clinical characteristics and molecular pathology.
In reconstructing the line of events from early thyroid hyperplasia to multinodular goiter we will argue the predominant neoplastic character of nodular structures, the nature of known somatic mutations and the importance of mutagenesis. Furthermore, we outline direct and indirect consequences of these somatic mutations for thyroid pathophysiology and summarize information concerning a possible genetic backround of euthyroid goiter.
Finally we discuss uncertainties/open questions in differential diagnosis and therapy of euthyroid and toxic multinodular goiter.
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